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Sample records for health program randomized

  1. Random assignment in clinical trials: issues in planning (Infant Health and Development Program).

    Science.gov (United States)

    Kraemer, H C; Fendt, K H

    1990-01-01

    Various options available for the randomization of subjects into groups in a clinical trial are discussed, emphasizing the issues of logistics given less focus in more mathematical treatments. We discuss advantages and disadvantages of total randomization, of Zelen-type randomization procedures, of Efron-type procedures vs more classical blocking procedures to control the balance between groups, and of Simon-Pocock-type procedures vs more classical stratification for controlling possible biases in prognostic factors. Finally, we discuss issues related to choice and implementation of randomization procedures. The discussion is illustrated with the processes of decision-making in a national collaborative randomized clinical trial, the Infant Health and Development Program.

  2. Income Transfers and Maternal Health: Evidence from a National Randomized Social Cash Transfer Program in Zambia.

    Science.gov (United States)

    Handa, Sudhanshu; Peterman, Amber; Seidenfeld, David; Tembo, Gelson

    2016-02-01

    There is promising recent evidence that poverty-targeted social cash transfers have potential to improve maternal health outcomes; however, questions remain surrounding design features responsible for impacts. In addition, virtually no evidence exists from the African region. This study explores the impact of Zambia's Child Grant Program on a range of maternal health utilization outcomes using a randomized design and difference-in-differences multivariate regression from data collected over 24 months from 2010 to 2012. Results indicate that while there are no measurable program impacts among the main sample, there are heterogeneous impacts on skilled attendance at birth among a sample of women residing in households having better access to maternal health services. The latter result is particularly interesting because of the overall low level of health care availability in program areas suggesting that dedicated program design or matching supply-side interventions may be necessary to leverage unconditional cash transfers in similar settings to impact maternal health.

  3. Randomized Control Trial of the 3Rs Health Knowledge Training Program for Persons with Intellectual Disabilities

    Science.gov (United States)

    Feldman, Maurice A.; Owen, Frances; Andrews, Amy E.; Tahir, Munazza; Barber, Rachel; Griffiths, Dorothy

    2016-01-01

    Background: Persons with intellectual disabilities (ID) experience a wide range of health problems. Research is needed on teaching persons with intellectual disabilities about their health to promote self-advocacy. This study used a RCT to evaluate a health knowledge training program for adults with intellectual disabilities and verbal skills.…

  4. Impact of a Text-Messaging Program on Adolescent Reproductive Health: A Cluster-Randomized Trial in Ghana.

    Science.gov (United States)

    Rokicki, Slawa; Cohen, Jessica; Salomon, Joshua A; Fink, Günther

    2017-02-01

    To evaluate whether text-messaging programs can improve reproductive health among adolescent girls in low- and middle-income countries. We conducted a cluster-randomized controlled trial among 756 female students aged 14 to 24 years in Accra, Ghana, in 2014. We randomized 38 schools to unidirectional intervention (n = 12), interactive intervention (n = 12), and control (n = 14). The unidirectional intervention sent participants text messages with reproductive health information. The interactive intervention engaged adolescents in text-messaging reproductive health quizzes. The primary study outcome was reproductive health knowledge at 3 and 15 months. Additional outcomes included self-reported pregnancy and sexual behavior. Analysis was by intent-to-treat. From baseline to 3 months, the unidirectional intervention increased knowledge by 11 percentage points (95% confidence interval [CI] = 7, 15) and the interactive intervention by 24 percentage points (95% CI = 19, 28), from a control baseline of 26%. Although we found no changes in reproductive health outcomes overall, both unidirectional (odds ratio [OR] = 0.14; 95% CI = 0.03, 0.71) and interactive interventions (OR = 0.15; 95% CI = 0.03, 0.86) lowered odds of self-reported pregnancy for sexually active participants. Text-messaging programs can lead to large improvements in reproductive health knowledge and have the potential to lower pregnancy risk for sexually active adolescent girls.

  5. Randomized trial of two e-learning programs for oral health students on secondary prevention of eating disorders.

    Science.gov (United States)

    DeBate, Rita D; Severson, Herbert H; Cragun, Deborah; Bleck, Jennifer; Gau, Jeff; Merrell, Laura; Cantwell, Carley; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William; Taris, Mark

    2014-01-01

    The purpose of this study was to test whether an interactive, web-based training program is more effective than an existing, flat-text, e-learning program at improving oral health students' knowledge, motivation, and self-efficacy to address signs of disordered eating behaviors with patients. Eighteen oral health classes of dental and dental hygiene students were randomized to either the Intervention (interactive program; n=259) or Alternative (existing program; n=58) conditions. Hierarchical linear modeling assessed for posttest differences between groups while controlling for baseline measures. Improvement among Intervention participants was superior to those who completed the Alternative program for three of the six outcomes: benefits/barriers, self-efficacy, and skills-based knowledge (effect sizes ranging from 0.43 to 0.87). This study thus suggests that interactive training programs may be better than flat-text e-learning programs for improving the skills-based knowledge and self-efficacy necessary for behavior change.

  6. The ACTIVATE study: results from a group-randomized controlled trial comparing a traditional worksite health promotion program with an activated consumer program.

    Science.gov (United States)

    Terry, Paul E; Fowles, Jinnet Briggs; Xi, Min; Harvey, Lisa

    2011-01-01

    PURPOSE. This study compares a traditional worksite-based health promotion program with an activated consumer program and a control program DESIGN. Group randomized controlled trial with 18-month intervention. SETTING. Two large Midwestern companies. SUBJECTS. Three hundred and twenty employees (51% response). INTERVENTION. The traditional health promotion intervention offered population-level campaigns on physical activity, nutrition, and stress management. The activated consumer intervention included population-level campaigns for evaluating health information, choosing a health benefits plan, and understanding the risks of not taking medications as prescribed. The personal development intervention (control group) offered information on hobbies. The interventions also offered individual-level coaching for high risk individuals in both active intervention groups. MEASURES. Health risk status, general health status, consumer activation, productivity, and the ability to evaluate health information. ANALYSIS. Multivariate analyses controlled for baseline differences among the study groups. RESULTS. At the population level, compared with baseline performance, the traditional health promotion intervention improved health risk status, consumer activation, and the ability to recognize reliable health websites. Compared with baseline performance, the activated consumer intervention improved consumer activation, productivity, and the ability to recognize reliable health websites. At the population level, however, only the activated consumer intervention improved any outcome more than the control group did; that outcome was consumer activation. At the individual level for high risk individuals, both traditional health coaching and activated consumer coaching positively affected health risk status and consumer activation. In addition, both coaching interventions improved participant ability to recognize a reliable health website. Consumer activation coaching also

  7. Effects of a three-month therapeutic lifestyle modification program to improve bone health in postmenopausal Korean women in a rural community: a randomized controlled trial.

    Science.gov (United States)

    Oh, Eui Geum; Yoo, Jae Yong; Lee, Jung Eun; Hyun, Sa Saeng; Ko, Il Sun; Chu, Sang Hui

    2014-08-01

    In this randomized controlled trial, we examined the effects of a 3-month therapeutic lifestyle modification (TLM) intervention on knowledge, self-efficacy, and health behaviors related to bone health in postmenopausal women in rural Korea. Forty-one women ages 45 or older were randomly assigned to either the intervention (n = 21) or control (n = 20) group. The intervention group completed a 12-week, 24-session TLM program of individualized health monitoring, group health education, exercise, and calcium-vitamin D supplementation. Compared with the control group, the intervention group showed significant increases in knowledge and self-efficacy and improvement in diet and exercise after 12 weeks, providing evidence that a comprehensive TLM program can be effective in improving health behaviors to maintain bone health in women at high risk of osteoporosis.

  8. Positive impact of child feeding training program for primary care health professionals: a cluster randomized field trial

    Directory of Open Access Journals (Sweden)

    Márcia Regina Vitolo

    2014-12-01

    Full Text Available OBJECTIVE: To assess the impact of a child feeding training program for primary care health professionals about breastfeeding and complementary feeding practices. METHODS: Cluster-randomized field trial conducted in the city of Porto Alegre, (RS, Brazil. Twenty primary health care centers (HCC were randomized into intervention (n = 9 and control (n = 11 groups. The health professionals (n = 200 at the intervention group centers received training about healthy feeding practices. Pregnant women were enrolled at the study. Up to six months of child's age, home visits were made to obtain variables related to breastfeeding and introduction of foods. RESULTS: 619 children were evaluated: 318 from the intervention group and 301 from the control group. Exclusive breastfeeding prevalence in the first (72.3 versus 59.4%; RR = 1.21; 95%CI 1.08 - 1.38, second (62.6 versus 48.2%; RR = 1.29; 95%CI 1.10 - 1.53, and third months of life (44.0% versus 34.6%; RR = 1.27; 95%CI 1.04 - 1.56 was higher in the intervention group compared to the control group. The prevalence of children who consumed meat four or five times per week was higher in the intervention group than in the control group (36.8 versus 22.6%; RR = 1.62; 95%CI 1.32 - 2.03. The prevalence of children who had consumed soft drinks (34.9 versus 52.5%; RR = 0.66; 95%CI 0.54 - 0.80, chocolate (24.5 versus 36.7% RR = 0.66 95%CI 0.53 - 0.83, petit suisse (68.9 versus 79.7; 95%CI 0.75 - 0.98 and coffee (10.4 versus 20.1%; RR = 0.51; 95%CI 0.31 - 0.85 in their six first months of life was lower in the intervention group. CONCLUSION: The training of health professionals had a positive impact on infant feeding practices, contributing to the promotion of child health.

  9. Health Programs for Veterans

    Science.gov (United States)

    ... Health Administration » Health Programs for Veterans Veterans Health Administration Health Programs for Veterans Beyond the doctors and nurses who ... Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ... Veterans Health Administration Veterans Benefits Administration National Cemetery ...

  10. The effects of an integrated health education and exercise program in community-dwelling older adults with hypertension: a randomized controlled trial.

    Science.gov (United States)

    Park, Yeon-Hwan; Song, Misoon; Cho, Be-Long; Lim, Jae-Young; Song, Wook; Kim, Seon-Ho

    2011-01-01

    the aim of this study was to examine the effectiveness of HAHA (Healthy Aging and Happy Aging) program, which is an integrated health education and exercise program for community-dwelling older adults with hypertension. older adults with hypertension from one senior center were randomly allocated to experimental (n=18) or control group (n=22). Experimental group received health education, individual counseling and tailored exercise program for 12 weeks. the mean ages were 71 years (experimental group) and 69 (control group). After the intervention, systolic blood pressure of experimental group was significantly decreased than that of control group. Scores of exercise self-efficacy, general health, vitality, social functioning, and mental health in SF-36 were statistically higher than those of control group. the HAHA program was effective in control of systolic blood pressure and improving self-efficacy for exercise and health-related quality of life. 2010 Elsevier Ireland Ltd. All rights reserved.

  11. The effectiveness of a construction worksite prevention program on work ability, health, and sick leave: Results from a cluster randomized controlled trial

    NARCIS (Netherlands)

    Oude Hengel, K.M.; Blatter, B.M.; Molen, H.F. van der; Bongers, P.M.; Beek, A.J. van der

    2013-01-01

    Objective This study aimed to investigate the effectiveness of a prevention program on work ability, health, and sick leave targeted at construction worksites. Methods A total of 15 departments (N=297 workers) from 6 construction companies participated in this cluster randomized controlled trial and

  12. Effects of a health education and telephone counseling program on patients with a positive fecal occult blood test result for colorectal cancer screening: A randomized controlled trial.

    Science.gov (United States)

    Chiu, Hui-Chuan; Hung, Hsin-Yuan; Lin, Hsiu-Chen; Chen, Shu-Ching

    2016-11-17

    Our purpose was to evaluate the effects of a health education and telephone counseling program on knowledge and attitudes about colorectal cancer and screening and the psychological impact of positive screening results. A randomized controlled trial was conducted with 2 groups using a pretest and posttest measures design. Patients with positive colorectal cancer screening results were selected and randomly assigned to an experimental (n = 51) or control (n = 51) group. Subjects in the experimental group received a health education and telephone counseling program, while the control group received routine care only. Patients were assessed pretest before intervention (first visit to the outpatient) and posttest at 4 weeks after intervention (4 weeks after first visit to the outpatient). Patients in the experimental group had a significantly better level of knowledge about colorectal cancer and the psychological impact of a positive screening result than did the control group. Analysis of covariance revealed that the health education and telephone counseling program had a significant main effect on colorectal cancer knowledge. A health education and telephone counseling program can improve knowledge about colorectal cancer and about the psychological impact in patients with positive colorectal cancer screening results. The health education and telephone counseling program is an easy, simple, and convenient method of improving knowledge, improving attitudes, and alleviating psychological distress in patients with positive colorectal cancer screening results, and this program can be expanded to other types of cancer screening. Copyright © 2016 John Wiley & Sons, Ltd.

  13. Randomized Trial of the Availability, Responsiveness and Continuity (ARC) Organizational Intervention for Improving Youth Outcomes in Community Mental Health Programs

    Science.gov (United States)

    Glisson, Charles; Hemmelgarn, Anthony; Green, Philip; Williams, Nathaniel J.

    2013-01-01

    Objectives: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC…

  14. Workplace exercise and educational program for improving fitness outcomes related to health in workers: a randomized controlled trial.

    Science.gov (United States)

    Vilela, Bianca Lima; Benedito Silva, Ana Amélia; de Lira, Claudio Andre Barbosa; Andrade, Marília dos Santos

    2015-03-01

    To investigate the effects of a workplace fitness and education program intervention on physical fitness of workers. Employees from a chemical plant (n = 60) participated in a 4-month longitudinal study. They were randomly distributed in control and experimental groups. The experimental group had 4 months of exercise training in 15-minute sessions. The following evaluations were performed before and after the training period: body composition, localized muscle strength, and flexibility. The experimental group showed a significant decrease in body fat (24.7%) and a significant increase in lean mass (6.1%), flexibility (17.9%), sit-up test performance (39.8%), and push-up test performance (29.8%) after the workplace fitness and education program compared with initial values. A structured program of physical exercise was effective in improving body composition, abdominal strength, upper limb strength, and flexibility in workers.

  15. Effects of a School-Based Social-Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial.

    Science.gov (United States)

    Bavarian, Niloofar; Lewis, Kendra M; Acock, Alan; DuBois, David L; Yan, Zi; Vuchinich, Samuel; Silverthorn, Naida; Day, Joseph; Flay, Brian R

    2016-02-01

    There is considerable research that suggests that school-based social-emotional programs can foster improved mental health and reduce problem behaviors for participating youth; in contrast, much less is known about the impact of these programs on physical health, even though some of these programs also include at least limited direct attention to promoting physical health behaviors. We examined the effects of one such program, Positive Action (PA), on physical health behaviors and body mass index (BMI), and tested for mediation of program effects through a measure of social-emotional and character development (SECD). Participating schools in the matched-pair, cluster-randomized trial were 14 low-performing K-8 Chicago Public Schools. We followed a cohort of students in each school from grades 3 to 8 (eight waves of data collection; 1170 total students). Student self-reports of health behaviors served as the basis for measures of healthy eating and exercise, unhealthy eating, personal hygiene, consistent bedtime, and SECD. We collected height and weight measurements at endpoint to calculate age- and gender-adjusted BMI z-scores. Longitudinal multilevel modeling analyses revealed evidence of favorable program effects on personal hygiene [effect size (ES) = 0.48], healthy eating and exercise (ES = 0.21), and unhealthy eating (ES = -0.19); in addition, BMI z-scores were lower among students in PA schools at endpoint (ES = -0.21). Program effects were not moderated by either gender or student mobility. Longitudinal structural equation modeling demonstrated mediation through SECD for healthy eating and exercise, unhealthy eating, and personal hygiene. Findings suggest that a SECD program without a primary focus on health behavior promotion can have a modest impact on outcomes in this domain during the childhood to adolescence transition.

  16. A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

    DEFF Research Database (Denmark)

    Jensen, Janet F.; Egerod, Ingrid; Bestle, Morten H.

    2016-01-01

    Purpose: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012...... and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC......). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and posttraumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. Results: At 12...

  17. A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

    DEFF Research Database (Denmark)

    Jensen, Janet F.; Egerod, Ingrid; Bestle, Morten H.

    2016-01-01

    Purpose: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. Methods: A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012...... and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC......). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and posttraumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. Results: At 12...

  18. A Field Test of a Web-Based Workplace Health Promotion Program to Improve Dietary Practices, Reduce Stress, and Increase Physical Activity: Randomized Controlled Trial

    Science.gov (United States)

    Billings, Douglas W; Hersch, Rebekah K; Back, Anita S; Hendrickson, April

    2007-01-01

    Background Most work sites engage in some form of health promotion programming designed to improve worker health and reduce health care costs. Although these programs have typically been delivered through combinations of seminars and print materials, workplace health promotion programs are increasingly being delivered through the Internet. Objective The purpose of this research was to evaluate the effectiveness of a Web-based multimedia health promotion program for the workplace, designed to improve dietary practices, reduce stress, and increase physical activity. Methods Using a randomized controlled trial design with pretest-posttest comparisons within each group, 419 employees of a human resources company were randomly assigned to the Web-based condition or to a condition that provided print materials on the same topics. All subjects were assessed at pretest and posttest through an online questionnaire containing multiple measures of health behavior and attitudes. The test period was 3 months. Questionnaire data were analyzed mainly by analysis of covariance and t tests. Results Retention rates were good for both groups—85% for the Web-based group and 87% for the print group. Subjects using the Web-based program performed significantly better than the print group on Attitudes Toward a Healthful Diet (F1,415 = 7.104, P = .008) and Dietary Stage of Change (F1,408 = 6.487, P = .01), but there were no significant group differences on the five other dietary measures. Both groups also showed improvement from pretest to posttest on most dietary measures, as indicated by significant t tests. Within the Web-based group, dosage analyses showed significant effects of the number of times the subject accessed the program on measures of Dietary Self-Efficacy (F2,203 = 5.270, P = .003), Attitudes Toward a Healthful Diet (F2,204 = 2.585, P = .045), and Dietary Stage of Change (F2,200 = 4.627, P = .005). No significant differences were found between the two groups on measures

  19. Amount of health care and self-care following a randomized clinical trial comparing flexion-distraction with exercise program for chronic low back pain

    Directory of Open Access Journals (Sweden)

    Keenum Michael

    2006-08-01

    Full Text Available Abstract Background Previous clinical trials have assessed the percentage of participants who utilized further health care after a period of conservative care for low back pain, however no chiropractic clinical trial has determined the total amount of care during this time and any differences based on assigned treatment group. The objective of this clinical trial follow-up was to assess if there was a difference in the total number of office visits for low back pain over one year after a four week clinical trial of either a form of physical therapy (Exercise Program or a form of chiropractic care (Flexion Distraction for chronic low back pain. Methods In this randomized clinical trial follow up study, 195 participants were followed for one year after a four-week period of either a form of chiropractic care (FD or a form of physical therapy (EP. Weekly structured telephone interview questions regarded visitation of various health care practitioners and the practice of self-care for low back pain. Results Participants in the physical therapy group demonstrated on average significantly more visits to any health care provider and to a general practitioner during the year after trial care (p Conclusion During a one-year follow-up, participants previously randomized to physical therapy attended significantly more health care visits than those participants who received chiropractic care.

  20. mHealth to Improve the Diet Among Low-Income Populations Enrolled in an Established U.S. Nutrition Program: Design and Rationale of a Randomized Controlled Trial

    OpenAIRE

    Heather Noel Fedesco; Evans, David A.; Nolan Kline; William Bart Collins

    2015-01-01

    Aim: To describe the theoretical basis, and implementation of a randomized controlled trial to improve the diet and nutrition of low-income families in the United States. Background: Numerous community and state-wide programs exist in the United States to help improve the health and well-being of people with low incomes. One state-wide program, Small Steps to Health (Small Steps), focuses on improving diet and nutrition among SNAP (Supplemental Nutrition Assistance Program) recipients. S...

  1. Effects of a School-Based Social-Emotional and Character Development Program on Health Behaviors: A Matched-Pair, Cluster-Randomized Controlled Trial

    OpenAIRE

    Bavarian, Niloofar; Lewis, Kendra M.; Acock, Alan; DuBois, David L.; Yan, Zi; Vuchinich, Samuel; Silverthorn, Naida; Day, Joseph; Flay, Brian R.

    2016-01-01

    There is considerable research that suggests that school-based social-emotional programs can foster improved mental health and reduce problem behaviors for participating youth; in contrast, much less is known about the impact of these programs on physical health, even though some of these programs also include at least limited direct attention to promoting physical health behaviors. We examined the effects of one such program, Positive Action (PA), on physical health behaviors and body mass i...

  2. Physical activity program for patients with dementia and their relative caregivers: randomized clinical trial in Primary Health Care (AFISDEMyF study).

    Science.gov (United States)

    Rodriguez-Sánchez, Emiliano; Criado-Gutiérrez, José María; Mora-Simón, Sara; Muriel-Diaz, M Paz; Gómez-Marcos, Manuel A; Recio-Rodríguez, José I; Patino-Alonso, M Carmen; Valero-Juan, Luis F; Maderuelo-Fernandez, José A; García-Ortiz, Luis

    2014-04-01

    The aging of the population has led to the increase of chronic diseases, especially dementia and cardiovascular diseases, and it has become necessary for their relatives to dedicate more time in caregiving.The objective in the first phase of this study is to evaluate the effectiveness of a Primary Health Care procedure to increase the physical activity of people with dementia and their relative caregivers. Also the effect on the cognitive state and cardiovascular risk will be assessed. Clinical, multicentric and randomized trial. A simple random sampling to select 134 patients diagnosed with dementia will be carried out. After contacting their relatives, his/her participation in the trial will be requested. A basal assessment will be made and the participants will be asigned to control or intervention group (1:1). The main measure will be the assessment of physical activity (podometer and 7-PAR) in patients and caregivers. In patients with dementia: ADAS-cog, functional degree and cardiovascular risk. In caregivers: cardiovascular risk, general health and quality of life. For 3 months, participants will receive instructions to do physical activity with an adapted program. This program will be designed and applied by Primary Health Care professionals in patients with dementia and their caregivers. The control group will receive regular care. An intention-to-treat analysis will be carried out by comparing the observed differences between basal, 6 and 12 months measures. Change in the mean of daily steps assessed with the podometer and 7-PAR will be the main result. If the main hypothesis is confirmed, it could be useful to improve the cognitive state of patients with dementia, as well as the cardiovascular risk of all of them. The results can be good to improve technical features of the devices that register the physical activity in the patients with dementia, and it could facilitate its commercialization. Clinical Trials.gov Identifier: NCT02044887.

  3. The use of the mHealth program Smarter Pregnancy in preconception care: rationale, study design and data collection of a randomized controlled trial.

    Science.gov (United States)

    van Dijk, Matthijs R; Oostingh, Elsje C; Koster, Maria P H; Willemsen, Sten P; Laven, Joop S E; Steegers-Theunissen, Régine P M

    2017-01-26

    Unhealthy nutrition and lifestyle contribute to the worldwide rising prevalence of non-communicable diseases. This also accounts for the reproductive population, in which unhealthy behavior affects fertility and pregnancy outcome. Maternal smoking, alcohol consumption and inadequate folic acid supplement use are strongly associated with fetal complications as small for gestational age, premature birth and congenital malformations. In the Netherlands 83% of the perinatal mortality rate is due to these complications and is relatively high compared to other European countries. In order to reduce this prevalence rate, preconception care should be focused on the promotion of health of prospective parents by identification and intervention on modifiable nutrition and lifestyle risk factors. We developed the personal mHealth program 'Smarter Pregnancy' (Dutch version available on: https://www.slimmerzwanger.nl ) to provide individual coaching and information to improve nutrition and lifestyle during the preconception period in order to improve health of the reproductive population and subsequent generations. Women between 18 and 45 years of age, and trying to conceive are eligible for inclusion in a randomized controlled trial. Participants are allocated either to a general population cohort or a subfertile (IVF/ICSI) population cohort. The intervention group receives personal online coaching based on the identified nutrition and lifestyle risk factors at baseline. Coaching comprises recipes, incentives, additional questions including feedback and text and e-mail messages, with a maximum of three per week. The control group only receives one recipe per week to maintain adherence to the program and prevent drop out. Screening questionnaires are send in both groups at 6, 12, 18, and 24 weeks of the program to monitor the change in the identified risk factors. We expect to demonstrate that the mHealth program 'Smarter Pregnancy' can effectively improve nutrition and

  4. Impact of the Mexican program for education, health, and nutrition (Progresa) on rates of growth and anemia in infants and young children: a randomized effectiveness study.

    Science.gov (United States)

    Rivera, Juan A; Sotres-Alvarez, Daniela; Habicht, Jean-Pierre; Shamah, Teresa; Villalpando, Salvador

    2004-06-02

    Malnutrition causes death and impaired health in millions of children. Existing interventions are effective under controlled conditions; however, little information is available on their effectiveness in large-scale programs. To document the short-term nutritional impact of a large-scale, incentive-based development program in Mexico (Progresa), which included a nutritional component. A randomized effectiveness study of 347 communities randomly assigned to immediate incorporation to the program in 1998 (intervention group; n = 205) or to incorporation in 1999 (crossover intervention group; n = 142). A random sample of children in those communities was surveyed at baseline and at 1 and 2 years afterward. Participants were from low-income households in poor rural communities in 6 central Mexican states. Children (N = 650) 12 months of age or younger (n = 373 intervention group; n = 277 crossover intervention group) were included in the analyses. Children and pregnant and lactating women in participating households received fortified nutrition supplements, and the families received nutrition education, health care, and cash transfers. Two-year height increments and anemia rates as measured by blood hemoglobin levels in participating children. Progresa was associated with better growth in height among the poorest and younger infants. Age- and length-adjusted height was greater by 1.1 cm (26.4 cm in the intervention group vs 25.3 cm in the crossover intervention group) among infants younger than 6 months at baseline and who lived in the poorest households. After 1 year, mean hemoglobin values were higher in the intervention group (11.12 g/dL; 95% confidence interval [CI], 10.9-11.3 g/dL) than in the crossover intervention group (10.75 g/dL; 95% CI, 10.5-11.0 g/dL) who had not yet received the benefits of the intervention (P =.01). There were no differences in hemoglobin levels between the 2 groups at year 2 after both groups were receiving the intervention. The age

  5. A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology.

    Science.gov (United States)

    Burckhardt, Rowan; Manicavasagar, Vijaya; Batterham, Philip J; Hadzi-Pavlovic, Dusan

    2016-08-01

    To date, most early intervention programs have been based on emotion regulation strategies that address dysfunctional cognitive appraisals, problem-solving skills, and rumination. Another emotion regulation strategy, 'acceptance' training, has largely been overlooked. To examine the efficacy of this strategy, a school-based mental health program combining positive psychology with acceptance and commitment therapy (Strong Minds) was evaluated in a randomized controlled trial with a sample of 267 Year 10 and 11 high-school students in Sydney, Australia. Mixed models for repeated measures examined whether the program led to reductions in symptoms amongst students who commenced the program with high depression, anxiety, and stress scores, and increased wellbeing scores amongst all students. Results demonstrated that compared to controls, participants in the Strong Minds condition with elevated symptom scores (n=63) reported significant reductions in depression (p=.047), stress (p=.01), and composite depression/anxiety symptoms (p=.02) with medium to strong effect sizes (Cohen's d=0.53, 0.74, and 0.57, respectively). Increased wellbeing (p=.03) in the total sample and decreased anxiety scores (p=.048) for students with elevated symptoms were significant for Year 10 students with medium effect sizes (Cohen's d=0.43 and 0.54, respectively). This study tentatively suggests that including the emotion regulation strategy of acceptance in early intervention programs may be effective in reducing symptoms and improving wellbeing in high school students. Further research to investigate the generalizability of these findings is warranted. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  6. Evaluating the effectiveness of psychosocial resilience training for heart health, and the added value of promoting physical activity: a cluster randomized trial of the READY program

    Directory of Open Access Journals (Sweden)

    Pakenham Kenneth I

    2009-11-01

    Full Text Available Abstract Background Depression and poor social support are significant risk factors for coronary heart disease (CHD, and stress and anxiety can trigger coronary events. People experiencing such psychosocial difficulties are more likely to be physically inactive, which is also an independent risk factor for CHD. Resilience training can target these risk factors, but there is little research evaluating the effectiveness of such programs. This paper describes the design and measures of a study to evaluate a resilience training program (READY to promote psychosocial well-being for heart health, and the added value of integrating physical activity promotion. Methods/Design In a cluster randomized trial, 95 participants will be allocated to either a waitlist or one of two intervention conditions. Both intervention conditions will receive a 10 × 2.5 hour group resilience training program (READY over 13 weeks. The program targets five protective factors identified from empirical evidence and analyzed as mediating variables: positive emotions, cognitive flexibility, social support, life meaning, and active coping. Resilience enhancement strategies reflect the six core Acceptance and Commitment Therapy processes (values, mindfulness, defusion, acceptance, self-as-context, committed action and Cognitive Behavior Therapy strategies such as relaxation training and social support building skills. Sessions include psychoeducation, discussions, experiential exercises, and home assignments. One intervention condition will include an additional session and ongoing content promoting physical activity. Measurement will occur at baseline, two weeks post intervention, and at eight weeks follow-up, and will include questionnaires, pedometer step logs, and physical and hematological measures. Primary outcome measures will include self-reported indicators of psychosocial well-being and depression. Secondary outcome measures will include self-reported indicators of

  7. A Randomized Controlled Study of a Group Intervention Program to Enhance Mental Health of Children of Illegal Migrant Workers

    Science.gov (United States)

    Meir, Yael; Slone, Michelle; Levis, Mira

    2014-01-01

    Background: The social-ecological environment of undocumented children of migrant workers includes varying levels of risk factors. Growing up in these conditions compromises children's development on all levels. Many of these children are in need of psychotherapy, however, due to limited resources, only a few of them receive mental health aid.…

  8. The PRESLO study: evaluation of a global secondary low back pain prevention program for health care personnel in a hospital setting. Multicenter, randomized intervention trial

    Directory of Open Access Journals (Sweden)

    Denis Angélique

    2012-11-01

    Full Text Available Abstract Background Common low back pain represents a major public health problem in terms of its direct cost to health care and its socio-economic repercussions. Ten percent of individuals who suffer from low back pain evolve toward a chronic case and as such are responsible for 75 to 80% of the direct cost of low back pain. It is therefore imperative to highlight the predictive factors of low back pain chronification in order to lighten the economic burden of low back pain-related invalidity. Despite being particularly affected by low back pain, Hospices Civils de Lyon (HCL personnel have never been offered a specific, tailor-made treatment plan. The PRESLO study (with PRESLO referring to Secondary Low Back Pain Prevention, or in French, PREvention Secondaire de la LOmbalgie, proposed by HCL occupational health services and the Centre Médico-Chirurgical et de Réadaptation des Massues – Croix Rouge Française, is a randomized trial that aims to evaluate the feasibility and efficiency of a global secondary low back pain prevention program for the low back pain sufferers among HCL hospital personnel, a population at risk for recurrence and chronification. This program, which is based on the concept of physical retraining, employs a multidisciplinary approach uniting physical activity, cognitive education about low back pain and lumbopelvic morphotype analysis. No study targeting populations at risk for low back pain chronification has as yet evaluated the efficiency of lighter secondary prevention programs. Methods/Design This study is a two-arm parallel randomized controlled trial proposed to all low back pain sufferers among HCL workers, included between October 2008 and July 2011 and followed over two years. The personnel following their usual treatment (control group and those following the global prevention program in addition to their usual treatment (intervention group are compared in terms of low back pain recurrence and the

  9. A cluster randomized-controlled trial of a classroom-based drama workshop program to improve mental health outcomes among immigrant and refugee youth in special classes.

    Science.gov (United States)

    Rousseau, Cécile; Beauregard, Caroline; Daignault, Katherine; Petrakos, Harriet; Thombs, Brett D; Steele, Russell; Vasiliadis, Helen-Maria; Hechtman, Lily

    2014-01-01

    The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups. Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10), tutoring (n = 10) or control status (n = 9), for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ) completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports), impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom. The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents. The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of the theatre

  10. A cluster randomized-controlled trial of a classroom-based drama workshop program to improve mental health outcomes among immigrant and refugee youth in special classes.

    Directory of Open Access Journals (Sweden)

    Cécile Rousseau

    Full Text Available The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups.Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10, tutoring (n = 10 or control status (n = 9, for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports, impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom.The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents.The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of

  11. The "Happy Heart" educational program for changes in health habits in children and their families: protocol for a randomized clinical trial.

    Science.gov (United States)

    Minossi, Vanessa; Pellanda, Lucia Campos

    2015-03-10

    The prevalence of childhood obesity increased worldwide in recent decades and is associated with risk factors for the development of chronic diseases in adulthood. Strategies for health promotion directed at an early age, with recommendation for healthy habits, can achieve good results. The objective of this study is to evaluate the effectiveness of an innovative, simple and cost effective educational program to improve eating habits, physical activity and the knowledge about healthy habits in children, as well as in their families, as compared to routine outpatient care. The study is designed as a randomized clinical trial. Sample size is estimated to include 37 children, aged between 7 and 11 years, and their guardians, randomized for an intervention or a control group. The intervention will consist of 11-weekly group meetings of nutritional education and distribution of explanatory material, with orientation about healthy food and family habits and physical activity. Recreational, simple and low cost resources, carefully designed for the presentation of contents to the children and parents, will be used in all meetings. The control group will receive standard outpatient care based in individual clinical practice guidelines. The primary outcomes will be changes in dietary habits, knowledge and physical activity of children and adults. The secondary outcomes will be changes of body mass index, waist circumference, systolic and diastolic blood pressure and laboratory tests, in children and adults. The Happy Heart Study offers a playful and low-cost approach for the prevention and control of obesity and cardiovascular disease in children. Although this program is being planned for implementation in Brazil, the method can be adapted to many other countries. Protocol registered on the site ensaiosclinicos.gov.br: RBR-8ttw64.

  12. Exercise and nutrition routine improving cancer health (ENRICH: The protocol for a randomized efficacy trial of a nutrition and physical activity program for adult cancer survivors and carers

    Directory of Open Access Journals (Sweden)

    Boyes Allison

    2011-04-01

    Full Text Available Abstract Background The Exercise and Nutrition Routine Improving Cancer Health (ENRICH study is investigating a novel lifestyle intervention aimed at improving the health behaviors of adult cancer survivors and their carers. The main purpose of the study is to determine the efficacy of lifestyle education and skill development delivered via group-based sessions on the physical activity and dietary behaviors of participants. This article describes the intervention development, study design, and participant recruitment. Methods/Design ENRICH is a randomized controlled trial, conducted in Australia, with two arms: an intervention group participating in six, two-hour face-to-face sessions held over eight weeks, and a wait-list control group. Intervention sessions are co-facilitated by an exercise physiologist and dietician. Content includes healthy eating education, and a home-based walking (utilizing a pedometer and resistance training program (utilizing elastic tubing resistance devices. The program was developed with reference to social cognitive theory and chronic disease self-management models. The study population consists of cancer survivors (post active-treatment and their carers recruited through community-based advertising and referral from health professionals. The primary outcome is seven-days of sealed pedometry. Secondary outcomes include: self-reported physical activity levels, dietary intake, sedentary behavior, waist circumference, body mass index, quality of life, and perceived social support. The outcomes will be measured at baseline (one week prior to attending the program, eight-weeks (at completion of intervention sessions, and 20-weeks. The intervention group will also be invited to complete 12-month follow-up data collection. Process evaluation data will be obtained from participants by questionnaire and attendance records. Discussion No trials are yet available that have evaluated the efficacy of group-based lifestyle

  13. A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study.

    Science.gov (United States)

    Jensen, Janet F; Egerod, Ingrid; Bestle, Morten H; Christensen, Doris F; Elklit, Ask; Hansen, Randi L; Knudsen, Heidi; Grode, Louise B; Overgaard, Dorthe

    2016-11-01

    The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and post-traumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. At 12 months, we found no differences in HRQOL between groups (mean difference in the Physical Component Summary score, 1.41 [95 % CI, -1.53 to 4.35; p = 0.35] (n = 235); and in the Mental Component Summary score, 1.92 [95 % CI, -1.06 to 4.90; p = 0.11] (n = 235). No differences were found on self-reported SOC (p = 0.63), anxiety (p = 0.68), depression (p = 0.67), PTSD (p = 0.27), or the utilization of healthcare services including rehabilitation. We found a difference on anxiety, when a cut-off point ≥11 was applied, in per protocol analysis of complete cases at 3 months favoring the intervention (8.8 % vs. 16.2 %, p = 0.04). The tested recovery program was not superior to standard care during the first 12 months post-ICU. The trial is registered at Clinicaltrials.gov, identification no. NCT01721239.

  14. Response Across the Health-Literacy Spectrum of Kidney Transplant Recipients to a Sun-Protection Education Program Delivered on Tablet Computers: Randomized Controlled Trial.

    Science.gov (United States)

    Robinson, June K; Friedewald, John J; Desai, Amishi; Gordon, Elisa J

    2015-08-18

    Sun protection can reduce skin cancer development in kidney transplant recipients, who have a greater risk of developing squamous cell carcinoma than the general population. A culturally sensitive sun-protection program (SunProtect) was created in English and Spanish with the option of choosing audio narration provided by the tablet computer (Samsung Galaxy Tab 2 10.1). The intervention, which showed skin cancer on patients with various skin tones, explained the following scenarios: skin cancer risk, the ability of sun protection to reduce this risk, as well as offered sun-protection choices. The length of the intervention was limited to the time usually spent waiting during a visit to the nephrologist. The development of this culturally sensitive, electronic, interactive sun-protection educational program, SunProtect, was guided by the "transtheoretical model," which focuses on decision making influenced by perceptions of personal risk or vulnerability to a health threat, importance (severity) of the disease, and benefit of sun-protection behavior. Transportation theory, which holds that narratives can have uniquely persuasive effects in overcoming preconceived beliefs and cognitive biases because people transported into a narrative world will alter their beliefs based on information, claims, or events depicted, guided the use of testimonials. Participant tablet use was self-directed. Self-reported responses to surveys were entered into the database through the tablet. Usability was tested through interviews. A randomized controlled pilot trial with 170 kidney transplant recipients was conducted, where the educational program (SunProtect) was delivered through a touch-screen tablet to 84 participants. The study involved 62 non-Hispanic white, 60 non-Hispanic black, and 48 Hispanic/Latino kidney transplant recipients. The demographic survey data showed no significant mean differences between the intervention and control groups in age, sex, income, or time since

  15. Open and Calm-A randomized controlled trial evaluating a public stress reduction program in Denmark Health behavior, health promotion and society

    DEFF Research Database (Denmark)

    Jensen, Christian Gaden; Lansner, Jon; Petersen, Anders

    2015-01-01

    .g., unstandardized consultations with their general practitioner. Outcomes included perceived stress, depressive symptoms, quality of life, sleep disturbances, mental health, salivary cortisol, and visual perception. Control variables comprised a genetic stress-resiliency factor (serotonergic transporter genotype; 5...

  16. The Well London program - a cluster randomized trial of community engagement for improving health behaviors and mental wellbeing: baseline survey results

    Directory of Open Access Journals (Sweden)

    Phillips Gemma

    2012-07-01

    Full Text Available Abstract Background The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT. The baseline survey data are reported here. Methods The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs; ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. Results There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of

  17. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Evers, S.; Ambergen, T.; Kempen, G.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population ra

  18. Effects of a 10-Day Intensive Health Promotion Program Combining Diet and Physical Activity on Body Composition, Physical Fitness, and Blood Factors of Young Adults: A Randomized Pilot Study.

    Science.gov (United States)

    Lee, Kyoung Soon; Lee, Jae Koo; Yeun, Young Ran

    2017-04-11

    BACKGROUND A lifestyle characterized by poor eating habits and physical inactivity is a risk factor for multiple lifestyle diseases in young adults. This study assessed the effects of implementing an intensive 10-day health promotion program combining diet and physical activities on body composition, physical fitness, and biochemical parameters of young adults. MATERIAL AND METHODS In this randomized pilot study, 30 female undergraduate students were randomly allocated to an intervention and a control group. The health promotion program consisted of unlimited amounts of vegetarian food; aerobic, flexibility, and strength exercises (3 hours/day); lectures on health (3 hours/day); massage practice (2 hours/day); and healthy cooking practice (1 hour/day). The effects of the intervention were analyzed using the Mann-Whitney U test and the Wilcoxon signed-rank test. RESULTS The intensive 10-day health promotion program significantly reduced body weight, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, blood glucose, and the homeostasis model assessment of insulin resistance. At the same time, participants demonstrated increased back muscle, leg muscle, and grip strength; waist and shoulder flexibility; balance; and cardiorespiratory endurance. CONCLUSIONS The intensive 10-day health promotion program is a viable intervention for improving body composition, physical fitness, glycemic control, and blood lipid levels in young adults.

  19. Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: a randomized controlled trial.

    NARCIS (Netherlands)

    Dechamps, A.A.; Diolez, P.; Thiaudiere, E.; Tulon, A.; Onifade, C.; Vuong, T.; Helmer, C.; Bourdel-Marchasson, I.

    2010-01-01

    BACKGROUND: Our objective was to assess the effects of targeted exercise programs on health-related quality of life compared with usual care based on the ability to perform activities of daily living (ADL) and the Neuropsychiatric Inventory scores in geriatric institutionalized persons. METHODS: A r

  20. The Effects of an E-Mental Health Program and Job Coaching on the Risk of Major Depression and Productivity in Canadian Male Workers: Protocol for a Randomized Controlled Trial

    Science.gov (United States)

    Patten, Scott B; Lam, Raymond W; Attridge, Mark; Ho, Kendall; Schmitz, Norbert; Marchand, Alain; Lashewicz, Bonnie M

    2016-01-01

    Background Major depression (MDE) is prevalent in men and affects men’s health and productivity. Because of the stigma against depression and social/gender norms, men are less likely to seek help for emotion and stress-related issues. Therefore, innovative solutions tailored for men are needed. With rapid development of the Internet and information technologies, one promising solution that has drawn considerable attentions is electronic mental (e-mental) health programs and services. Objective The objective of our study is to evaluate the effectiveness of the e-mental health program BroHealth on reducing the risk of having MDE and improving productivity and return to investment. Methods The target population is Canadian working men who are at high risk of having MDE (N=1200). Participants will be recruited using the method of random digit dialing across the country and workplace advertisement. Eligible participants will be randomly allocated into the following groups: (1) a control group, (2) a group receiving BroHealth only, and (3) a group receiving BroHealth and telephone-based job coaching service. The groups will be assessed at 6 and 12 months after randomization. The primary outcome is the risk proportion of MDE over 12 months, which will be assessed by the World Health Organization's (WHO’s) Composite International Diagnostic Interview-Short Form for Major Depression. Intention-to-treat principle will be used in the analysis. The 12-month proportions of MDE in the groups will be estimated and compared. Logistic regression modeling will be used to examine the effect of the intervention on the outcome, controlling for the effects of baseline confounders. Results It is anticipated that the randomized controlled trial (RCT) will be completed by 2018. This study has been approved by the Conjoint Health Research Ethics Review Board of the University of Calgary. The trial is funded by a team grant from the Movember Foundation, a global charity for men

  1. Clinic Health Awareness Program Subsystem -

    Data.gov (United States)

    Department of Transportation — Clinic Health Awareness Program Subystem (CHAPS) is a comprehensive system for recording, reporting, and analyzing a patient’s medical information and managing an...

  2. Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Elisabeth Wiken Telenius

    Full Text Available Dementia is among the leading causes of functional loss and disability in older adults. Research has demonstrated that nursing home patients without dementia can improve their function in activities of daily living, strength, balance and mental well being by physical exercise. The evidence on effect of physical exercise among nursing home patients with dementia is scarce and ambiguous. Thus, the primary objective of this study was to investigate the effect of a high intensity functional exercise program on the performance of balance in nursing home residents with dementia. The secondary objective was to examine the effect of this exercise on muscle strength, mobility, activities of daily living, quality of life and neuropsychiatric symptoms.This single blinded randomized controlled trial was conducted among 170 persons with dementia living in nursing homes. Mean age was 86.7 years (SD = 7.4 and 74% were women. The participants were randomly allocated to an intervention (n = 87 or a control group (n = 83. The intervention consisted of intensive strengthening and balance exercises in small groups twice a week for 12 weeks. The control condition was leisure activities.The intervention group improved the score on Bergs Balance Scale by 2.9 points, which was significantly more than the control group who improved by 1.2 points (p = 0.02. Having exercised 12 times or more was significantly associated with improved strength after intervention (p<0.05. The level of apathy was lower in the exercise group after the intervention, compared to the control group (p = 0.048.The results from our study indicate that a high intensity functional exercise program improved balance and muscle strength as well as reduced apathy in nursing home patients with dementia.ClinicalTrials.gov NCT02262104.

  3. Migrant Health - Legislation and Programs.

    Science.gov (United States)

    National Migrant Information Clearinghouse, Austin, TX. Juarez-Lincoln Center.

    The Public Health Service Act was amended in 1962 to authorize grants to establish family health service clinics for domestic agricultural migratory workers and to improve the health conditions of these workers and their families. Approximately 100 programs currently provide migrant health services. As a result of the low level of funding of these…

  4. The protocol of a randomized controlled trial for playgroup mothers: Reminder on Food, Relaxation, Exercise, and Support for Health (REFRESH Program

    Directory of Open Access Journals (Sweden)

    Monteiro Sarojini MDR

    2011-08-01

    Full Text Available Abstract Background Mother's physical activity levels are relatively low, while their energy consumption is generally high resulting in 58% of Australian women over the age of 18 years being overweight or obese. This study aims to confirm if a low-cost, accessible playgroup based intervention program can improve the dietary and physical activity behaviours of mothers with young children. Methods/Design The current study is a randomized controlled trial lifestyle (nutrition and physical activity intervention for mothers with children aged between 0 to 5 years attending playgroups in Perth, Western Australia. Nine-hundred participants will be recruited and randomly assigned to the intervention (n = 450 and control (n = 450 groups. The study is based on the Social Cognitive Theory (SCT and the Transtheoretical Model (TTM, and the Precede-Proceed Framework incorporating goal setting, motivational interviewing, social support and self-efficacy. The six month intervention will include multiple strategies and resources to ensure the engagement and retention of participants. The main strategy is home based and will include a specially designed booklet with dietary and physical activity information, a muscle strength and flexibility exercise chart, a nutrition label reading shopping list and menu planner. The home based strategy will be supported by face-to-face dietary and physical activity workshops in the playgroup setting, posted and emailed bi-monthly newsletters, and monthly Short Message Service (SMS reminders via mobile phones. Participants in the control group receive no intervention materials. Outcome measures will be assessed using data that will be collected at baseline, six months and 12 months from participants in the control and intervention groups. Discussion This trial will add to the evidence base on the recruitment, retention and the impact of community based dietary and physical activity interventions for mothers with young children

  5. 49 CFR 219.601 - Railroad random drug testing programs.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Railroad random drug testing programs. 219.601... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION CONTROL OF ALCOHOL AND DRUG USE Random Alcohol and Drug Testing Programs § 219.601 Railroad random drug testing programs. (a) Submission. Each railroad must submit for FRA...

  6. Alaska Dental Health Aide Program

    Directory of Open Access Journals (Sweden)

    Sarah Shoffstall-Cone

    2013-08-01

    Full Text Available Background. In 1999, An Oral Health Survey of American Indian and Alaska Native (AI/AN Dental Patients found that 79% of 2- to 5-year-olds had a history of tooth decay. The Alaska Native Tribal Health Consortium in collaboration with Alaska’s Tribal Health Organizations (THO developed a new and diverse dental workforce model to address AI/AN oral health disparities. Objectives. This paper describes the workforce model and some experience to date of the Dental Health Aide (DHA Initiative that was introduced under the federally sanctioned Community Health Aide Program in Alaska. These new dental team members work with THO dentists and hygienists to provide education, prevention and basic restorative services in a culturally appropriate manner. Results. The DHA Initiative introduced 4 new dental provider types to Alaska: the Primary Dental Health Aide, the Expanded Function Dental Health Aide, the Dental Health Aide Hygienist and the Dental Health Aide Therapist. The scope of practice between the 4 different DHA providers varies vastly along with the required training and education requirements. DHAs are certified, not licensed, providers. Recertification occurs every 2 years and requires the completion of 24 hours of continuing education and continual competency evaluation. Conclusions. Dental Health Aides provide evidence-based prevention programs and dental care that improve access to oral health care and help address well-documented oral health disparities.

  7. [Mental health in the family health program].

    Science.gov (United States)

    Souza, Aline de Jesus Fontineli; Matias, Gina Nogueira; Gomes, Kenia de Fátima Alencar; Parente, Adriana da Cunha Menezes

    2007-01-01

    A descriptive study whose objective was to identify the education and actions of the nurse in Mental Health (MH), in the Family Health Program. The sample consisted of 134 acting nurses at the Family Health Program in Teresina, Piauí The results show that 95.5% don't have the specified education in MH. Of those interviewed, 97% state that there are patients, in their assigned areas, that need this type of care. The referenced actions were home visits (60%) appointments (27.7%), referrals (21.5%), medication delivery (15.4%), inactivity (14.6%), ambulatory service (7.7%), community therapy (5.4%) and casework (0.8%). Methods and strategies of public policies related to this area should be revisited and instituted in order to (re)direct ways of reform in the actions and services of mental health.

  8. Evaluation of a health promotion program in children: Study protocol and design of the cluster-randomized Baden-Württemberg primary school study [DRKS-ID: DRKS00000494

    Directory of Open Access Journals (Sweden)

    Dreyhaupt Jens

    2012-03-01

    Full Text Available Abstract Background Increasing prevalences of overweight and obesity in children are known problems in industrialized countries. Early prevention is important as overweight and obesity persist over time and are related with health problems later in adulthood. "Komm mit in das gesunde Boot - Grundschule" is a school-based program to promote a healthier lifestyle. Main goals of the intervention are to increase physical activity, decrease the consumption of sugar-sweetened beverages, and to decrease time spent sedentary by promoting active choices for healthy lifestyle. The program to date is distributed by 34 project delivery consultants in the state of Baden-Württemberg and is currently implemented in 427 primary schools. The efficacy of this large scale intervention is examined via the Baden-Württemberg Study. Methods/Design The Baden-Württemberg Study is a prospective, stratified, cluster-randomized, and longitudinal study with two groups (intervention group and control group. Measurements were taken at the beginning of the academic years 2010/2011 and 2011/2012. Efficacy of the intervention is being assessed using three main outcomes: changes in waist circumference, skinfold thickness and 6 minutes run. Stratified cluster-randomization (according to class grade level was performed for primary schools; pupils, teachers/principals, and parents were investigated. An approximately balanced number of classes in intervention group and control group could be reached by stratified randomization and was maintained at follow-up. Discussion At present, "Komm mit in das Gesunde Boot - Grundschule" is the largest school-based health promotion program in Germany. Comparative objective main outcomes are used for the evaluation of efficacy. Simulations showed sufficient power with the existing sample size. Therefore, the results will show whether the promotion of a healthier lifestyle in primary school children is possible using a relatively low effort

  9. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: Protocol for a Randomized Study Funded by the US Department of Veterans Affairs Health Services Research and Development Program.

    Science.gov (United States)

    Piette, John D; Krein, Sarah L; Striplin, Dana; Marinec, Nicolle; Kerns, Robert D; Farris, Karen B; Singh, Satinder; An, Lawrence; Heapy, Alicia A

    2016-04-07

    Cognitive behavioral therapy (CBT) is one of the most effective treatments for chronic low back pain. However, only half of Department of Veterans Affairs (VA) patients have access to trained CBT therapists, and program expansion is costly. CBT typically consists of 10 weekly hour-long sessions. However, some patients improve after the first few sessions while others need more extensive contact. We are applying principles from "reinforcement learning" (a field of artificial intelligence or AI) to develop an evidence-based, personalized CBT pain management service that automatically adapts to each patient's unique and changing needs (AI-CBT). AI-CBT uses feedback from patients about their progress in pain-related functioning measured daily via pedometer step counts to automatically personalize the intensity and type of patient support. The specific aims of the study are to (1) demonstrate that AI-CBT has pain-related outcomes equivalent to standard telephone CBT, (2) document that AI-CBT achieves these outcomes with more efficient use of clinician resources, and (3) demonstrate the intervention's impact on proximal outcomes associated with treatment response, including program engagement, pain management skill acquisition, and patients' likelihood of dropout. In total, 320 patients with chronic low back pain will be recruited from 2 VA healthcare systems and randomized to a standard 10 sessions of telephone CBT versus AI-CBT. All patients will begin with weekly hour-long telephone counseling, but for patients in the AI-CBT group, those who demonstrate a significant treatment response will be stepped down through less resource-intensive alternatives including: (1) 15-minute contacts with a therapist, and (2) CBT clinician feedback provided via interactive voice response calls (IVR). The AI engine will learn what works best in terms of patients' personally tailored treatment plans based on daily feedback via IVR about their pedometer-measured step counts, CBT skill

  10. School Health and Nutrition Programs

    Directory of Open Access Journals (Sweden)

    Nurcan Yabanci

    2011-06-01

    Full Text Available Schools play an effective role for adopt and maintain healthy eating and physical activity behaviors in children and adolescents. Schools are an important part of national efforts to prevent chronic diseases such as childhood obesity, coronary heart diseases, diabetes and cancer. Nutrition programs in schools can help children and adolescents participate in full educational potential; improve academic performance and health quality. To ensure a healthy future for our children, school-based nutrition education programs must become a national priority. Governments, community leaders, doctors, dieteticians, nurses, teachers, and parents must commit to implementing and sustaining nutrition education programs within the schools. School health and nutrition programs which part of public health and education are summarized in this review. [TAF Prev Med Bull 2011; 10(3.000: 361-368

  11. Evaluation of the College Possible Program: Results from a Randomized

    Science.gov (United States)

    Avery, Christopher

    2013-01-01

    This paper reports the results of a randomized trial of the College Possible program, which provides two years of college preparatory work for high school juniors and seniors in Minneapolis and St. Paul. The trial involved 238 students, including 134 who were randomly selected for admission to the program. The results indicate that the College…

  12. An Exercise Program in Youngsters with Complex Congenital Heart Disease: does it improve Health Related Quality of Life and Psychosocial Functioning? A randomized controlled trial

    NARCIS (Netherlands)

    K. Dulfer (Karolijn)

    2014-01-01

    markdownabstract__Abstract__ A 12-week standardized exercise program improved self-reported cognitive functioning, and parent-reported social functioning in children and adolescents with complex congenital heart disease. Furthermore, it resulted in a decrease in passive leisure time spending. In co

  13. Improving Blood Pressure Control through a Clinical Pharmacist Outreach Program in Diabetes Patients in Two-High Performing Health Systems: The Adherence and Intensification of Medications (AIM) Cluster Randomized Controlled Pragmatic Trial

    Science.gov (United States)

    Heisler, Michele; Hofer, Timothy P.; Schmittdiel, Julie A.; Selby, Joe V.; Klamerus, Mandi L.; Bosworth, Hayden B.; Bermann, Martin; Kerr, Eve A.

    2013-01-01

    Background Even in high performing health systems, some hypertensive patients with diabetes have persistent poor blood pressure (BP) control. Medication nonadherence and lack of medication intensification contribute to this poor control. We examined whether the Adherence and Intensification of Medications (AIM) intervention, a targeted pharmacist-led intervention that combined state-of-the-art elements found in efficacy studies to lower BP, could improve BP among diabetes patients with persistent hypertension and poor refill adherence or insufficient medication intensification. Methods and Results We conducted a prospective, multi-site cluster randomized pragmatic trial with randomization of 16 primary care teams at five medical centers (3 Veterans Affairs [VA] and 2 Kaiser Permanente [KP]) to the AIM intervention or usual care. The primary outcome was the relative change in systolic blood pressure (SBP) measurements, comparing 1,797 eligible intervention team patients to 2,303 eligible control team patients, between the 6-months preceding and the 6-months following the 14-month intervention period. We examined shorter-term changes in SBP as a secondary outcome. In our primary analysis, the intervention group SBP change from 6-months prior to 6-months after the 14-month intervention period was approximately the same as the control group, declining approximately 9 mm Hg in both groups. SBP lowering occurred more rapidly among eligible intervention team patients, with mean SBPs 2.4 mm Hg lower (95% CI: −3.4 to −1.5; p<.001) immediately after the intervention than those achieved by eligible control patients. Conclusions The AIM program more rapidly lowered SBPs among eligible intervention patients, but there was no significant difference in blood pressure between intervention and control patients 6 months following the intervention period. These findings show the importance of rigorously evaluating in different real-life clinical settings programs found in

  14. 3 CFR - State Children's Health Insurance Program

    Science.gov (United States)

    2010-01-01

    ... 3 The President 1 2010-01-01 2010-01-01 false State Children's Health Insurance Program... Insurance Program Memorandum for the Secretary of Health and Human Services The State Children's Health Insurance Program (SCHIP) encourages States to provide health coverage for uninsured children in families...

  15. Impact of a nurse-directed, coordinated school health program to enhance physical activity behaviors and reduce body mass index among minority children: a parallel-group, randomized control trial.

    Science.gov (United States)

    Wright, Kynna; Giger, Joyce Newman; Norris, Keth; Suro, Zulma

    2013-06-01

    Underserved children, particularly girls and those in urban communities, do not meet the recommended physical activity guidelines (>60min of daily physical activity), and this behavior can lead to obesity. The school years are known to be a critical period in the life course for shaping attitudes and behaviors. Children look to schools for much of their access to physical activity. Thus, through the provision of appropriate physical activity programs, schools have the power to influence apt physical activity choices, especially for underserved children where disparities in obesity-related outcomes exist. To evaluate the impact of a nurse directed, coordinated, culturally sensitive, school-based, family-centered lifestyle program on activity behaviors and body mass index. This was a parallel group, randomized controlled trial utilizing a community-based participatory research approach, through a partnership with a University and 5 community schools. Participants included 251 children ages 8-12 from elementary schools in urban, low-income neighborhoods in Los Angeles, USA. The intervention included Kids N Fitness(©), a 6-week program which met weekly to provide 45min of structured physical activity and a 45min nutrition education class for parents and children. Intervention sites also participated in school-wide wellness activities, including health and counseling services, staff professional development in health promotion, parental education newsletters, and wellness policies for the provision of healthy foods at the school. The Child and Adolescent Trial for Cardiovascular Health School Physical Activity and Nutrition Student Questionnaire measured physical activity behavior, including: daily physical activity, participation in team sports, attending physical education class, and TV viewing/computer game playing. Anthropometric measures included height, weight, body mass index, resting blood pressure, and waist circumference. Measures were collected at baseline

  16. mHealth to Improve the Diet Among Low-Income Populations Enrolled in an Established U.S. Nutrition Program: Design and Rationale of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Heather Noel Fedesco

    2015-10-01

    Full Text Available Aim: To describe the theoretical basis, and implementation of a randomized controlled trial to improve the diet and nutrition of low-income families in the United States. Background: Numerous community and state-wide programs exist in the United States to help improve the health and well-being of people with low incomes. One state-wide program, Small Steps to Health (Small Steps, focuses on improving diet and nutrition among SNAP (Supplemental Nutrition Assistance Program recipients. Small Steps is a series of 10 1-hour educational classes that focus on a range of nutritional and diet topics, including: how to read food labels, how to prepare and cook home meals, as well as various ways to improve diet (e.g., reducing fat/sugar and increasing fruit/vegetable consumption. This program has been found to be effective in increasing vegetable consumption, meal planning, and physical activity. However, there has been no difference found in overall diet change nor in difficult diet behavior change, such as eliminating sugary drinks, reducing fast food intake, and replacing high-fat and sugar snacks with healthier options. Changing difficult behaviors requires more than education. For example, research shows that learning why sugary drinks are unhealthy is not enough to stop people from drinking these beverages. Beyond education, people benefit from counseling that focuses on increasing motivation and confidence, assistance with overcoming barriers, identifying social support, and creating specific action plans. Providing behavior change counseling to large numbers of people is challenging, however. Widespread use of short-message services (SMS provides one potential tool for researchers to help individuals change difficult behaviors. For instance, SMS intervention is effective at helping smokers reduce or eliminate cigarettes, increase patients adherence to various medical regiments, and most importantly, aid in weight loss. Although promising, one of

  17. Post-9/11 Veterans and Their Partners Improve Mental Health Outcomes with a Self-directed Mobile and Web-based Wellness Training Program: A Randomized Controlled Trial.

    Science.gov (United States)

    Kahn, Janet R; Collinge, William; Soltysik, Robert

    2016-09-27

    Veterans with history of deployment in the Global War on Terror face significant and ongoing challenges with high prevalences of adverse psychological, physical, spiritual, and family impacts. Together, these challenges contribute to an emerging public health crisis likely to extend well into the future. Innovative approaches are needed that reach veterans and their family members with strategies they can employ over time in their daily lives to promote improved adjustment and well-being. The objective of this study was to evaluate effects of use of a Web-based, self-directed program of instruction in mind- and body-based wellness skills to be employed by Global War on Terror veterans and their significant relationship partners on mental health and wellness outcomes associated with postdeployment readjustment. We recruited 160 veteran-partner dyads in 4 regions of the United States (San Diego, CA; Dallas, TX; Fayetteville, NC; and New York, NY) through publicity by the Iraq and Afghanistan Veterans of America to its membership. Dyads were randomly allocated to 1 of 4 study arms: Mission Reconnect (MR) program alone, MR plus the Prevention and Relationship Enhancement Program (PREP) for Strong Bonds weekend program for military couples, PREP alone, and waitlist control. We administered a battery of standardized and investigator-generated instruments assessing mental health outcomes at baseline, 8 weeks, and 16 weeks. Dyads in the MR arms were provided Web-based and mobile app video and audio instruction in a set of mindfulness-related stress reduction and contemplative practices, as well as partner massage for reciprocal use. All participants provided weekly reports on frequency and duration of self-care practices for the first 8 weeks, and at 16 weeks. During the first 8-week reporting period, veterans and partners assigned to MR arms used some aspect of the program a mean of 20 times per week, totaling nearly 2.5 hours per week, with only modest declines in use at

  18. Post-9/11 Veterans and Their Partners Improve Mental Health Outcomes with a Self-directed Mobile and Web-based Wellness Training Program: A Randomized Controlled Trial

    Science.gov (United States)

    Soltysik, Robert

    2016-01-01

    Background Veterans with history of deployment in the Global War on Terror face significant and ongoing challenges with high prevalences of adverse psychological, physical, spiritual, and family impacts. Together, these challenges contribute to an emerging public health crisis likely to extend well into the future. Innovative approaches are needed that reach veterans and their family members with strategies they can employ over time in their daily lives to promote improved adjustment and well-being. Objective The objective of this study was to evaluate effects of use of a Web-based, self-directed program of instruction in mind- and body-based wellness skills to be employed by Global War on Terror veterans and their significant relationship partners on mental health and wellness outcomes associated with postdeployment readjustment. Methods We recruited 160 veteran-partner dyads in 4 regions of the United States (San Diego, CA; Dallas, TX; Fayetteville, NC; and New York, NY) through publicity by the Iraq and Afghanistan Veterans of America to its membership. Dyads were randomly allocated to 1 of 4 study arms: Mission Reconnect (MR) program alone, MR plus the Prevention and Relationship Enhancement Program (PREP) for Strong Bonds weekend program for military couples, PREP alone, and waitlist control. We administered a battery of standardized and investigator-generated instruments assessing mental health outcomes at baseline, 8 weeks, and 16 weeks. Dyads in the MR arms were provided Web-based and mobile app video and audio instruction in a set of mindfulness-related stress reduction and contemplative practices, as well as partner massage for reciprocal use. All participants provided weekly reports on frequency and duration of self-care practices for the first 8 weeks, and at 16 weeks. Results During the first 8-week reporting period, veterans and partners assigned to MR arms used some aspect of the program a mean of 20 times per week, totaling nearly 2.5 hours per week

  19. Costs and effects of a state-wide health promotion program in primary schools in Germany – the Baden-Württemberg Study: A cluster-randomized, controlled trial

    Science.gov (United States)

    Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

    2017-01-01

    Aim To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program “Join the Healthy Boat” in primary schools in Germany. Methods Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. Results The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. Conclusion This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. Trial registration German Clinical Trials Register (DRKS), Freiburg University, Germany

  20. 78 FR 59121 - Basic Health Program: State Administration of Basic Health Programs; Eligibility and Enrollment...

    Science.gov (United States)

    2013-09-25

    ... 42 CFR Part 600 Office of the Secretary 45 CFR Part 144 Basic Health Program: State Administration of... Standard Health Plans; Performance Standards for Basic Health Programs; Premium and Cost Sharing for Basic... CFR Part 144 RIN 0938-AR93 Basic Health Program: State Administration of Basic Health...

  1. Promoting Early Intervention Referral through a Randomized Controlled Home-Visiting Program

    Science.gov (United States)

    Schwarz, Donald F.; O'Sullivan, Ann L.; Guinn, Judith; Mautone, Jennifer A.; Carlson, Elyse C.; Zhao, Huaqing; Zhang, Xuemei; Esposito, Tara L.; Askew, Megan; Radcliffe, Jerilynn

    2012-01-01

    The MOM Program is a randomized, controlled trial of an intervention to promote mothers' care for the health and development of their children, including accessing early intervention (EI) services. Study aims were to determine whether, relative to controls, this intervention increased receipt of and referral to EI services. Mothers (N = 302)…

  2. Factors Associated with High Use of a Workplace Web-Based Stress Management Program in a Randomized Controlled Intervention Study

    Science.gov (United States)

    Hasson, H.; Brown, C.; Hasson, D.

    2010-01-01

    In web-based health promotion programs, large variations in participant engagement are common. The aim was to investigate determinants of high use of a worksite self-help web-based program for stress management. Two versions of the program were offered to randomly selected departments in IT and media companies. A static version of the program…

  3. How chaosity and randomness control human health

    Science.gov (United States)

    Yulmetyev, Renat M.; Yulmetyeva, Dinara; Gafarov, Fail M.

    2005-08-01

    We discuss the fundamental role that chaosity and randomness play in the determination of quality and efficiency of medical treatment. The statistical parameter of non-Markovity from non-equilibrium statistical physics of condensed matters is offered as a quantitative information measure of chaosity and randomness. The role of chaosity and randomness is determined by the phenomenological property, which includes quantitative informational measures of chaosity and randomness and pathology (disease) in a covariant form. Manifestations of the statistical informational behavior of chaosity and randomness are examined while analyzing the chaotic dynamics of RR intervals from human ECG's, the electric signals of a human muscle's tremor of legs in a normal state and at Parkinson disease, the electric potentials of the human brain core from EEG's during epileptic seizure and a human hand finger tremor in Parkinson's disease. The existence of the above stated informational measure allows to introduce the quantitative factor of the quality of treatment. The above-stated examples confirm the existence of new phenomenological property, which is important not only for the decision of medical problems, but also for the analysis of the wide range of problems of physics of complex systems of life and lifeless nature.

  4. Randomized Controlled Trial of Primary Care Pediatric Parenting Programs

    Science.gov (United States)

    Mendelsohn, Alan L.; Dreyer, Benard P.; Brockmeyer, Carolyn A.; Berkule-Silberman, Samantha B.; Huberman, Harris S.; Tomopoulos, Suzy

    2011-01-01

    Objectives To determine whether pediatric primary care–based programs to enhance parenting and early child development reduce media exposure and whether enhanced parenting mediates the effects. Design Randomized controlled trial. Setting Urban public hospital pediatric primary care clinic. Participants A total of 410 mother-newborn dyads enrolled after childbirth. Interventions Patients were randomly assigned to 1 of 2 interventions, the Video Interaction Project (VIP) and Building Blocks (BB) interventions, or to a control group. The VIP intervention comprised 1-on-1 sessions with a child development specialist who facilitated interactions in play and shared reading through review of videotapes made of the parent and child on primary care visit days; learning materials and parenting pamphlets were also provided. The BB intervention mailed parenting materials, including age-specific newsletters suggesting activities to facilitate interactions, learning materials, and parent-completed developmental questionnaires (Ages and Stages questionnaires). Outcome Measures Electronic media exposure in the home using a 24-hour recall diary. Results The mean (SD) exposure at 6 months was 146.5 (125.0) min/d. Exposure to VIP was associated with reduced total duration of media exposure compared with the BB and control groups (mean [SD] min/d for VIP, 131.6 [118.7]; BB, 151.2 [116.7]; control, 155.4 [138.7]; P=.009). Enhanced parent-child interactions were found to partially mediate relations between VIP and media exposure for families with a ninth grade or higher literacy level (Sobel statistic=2.49; P=.01). Conclusion Pediatric primary care may represent an important venue for addressing the public health problem of media exposure in young children at a population level. Trial Registration clinicaltrials.gov Identifier: NCT00212576 PMID:21199979

  5. A multilingual population health management program.

    Science.gov (United States)

    Tsui, Edison W; Wang, Grace; Zahler, Abbie; Simoyan, Olapeju M; White, Mark V; Mckee, Michael

    2013-01-01

    Many small- and medium-sized physician practices have developed specific programs and models toward becoming a successful patient-centered medical home. This article reports on a case-control quality improvement study of a multilingual population health management program for chronic disease management at International Community Health Services. In its first 2.5 years of operation, the International Community Health Services Population Health Management program for patients with hypertension and diabetes is associated with significant improvements in key health outcome measures for blood pressure and hemoglobin A1c control. This has significant implications for similar practices.

  6. Randomized Trial of Four Financial-Incentive Programs for Smoking Cessation

    Science.gov (United States)

    Halpern, Scott D.; French, Benjamin; Small, Dylan S.; Saulsgiver, Kathryn; Harhay, Michael O.; Audrain-McGovern, Janet; Loewenstein, George; Brennan, Troyen A.; Asch, David A.; Volpp, Kevin G.

    2015-01-01

    BACKGROUND Financial incentives promote many health behaviors, but effective ways to deliver health incentives remain uncertain. METHODS We randomly assigned CVS Caremark employees and their relatives and friends to one of four incentive programs or to usual care for smoking cessation. Two of the incentive programs targeted individuals, and two targeted groups of six participants. One of the individual-oriented programs and one of the group-oriented programs entailed rewards of approximately $800 for smoking cessation; the others entailed refundable deposits of $150 plus $650 in reward payments for successful participants. Usual care included informational resources and free smoking-cessation aids. RESULTS Overall, 2538 participants were enrolled. Of those assigned to reward-based programs, 90.0% accepted the assignment, as compared with 13.7% of those assigned to deposit-based programs (Pincentive programs (range, 9.4 to 16.0%) than with usual care (6.0%) (Preward-based programs was sustained through 12 months. Group-oriented and individual-oriented programs were associated with similar 6-month abstinence rates (13.7% and 12.1%, respectively; P = 0.29). Reward-based programs were associated with higher abstinence rates than deposit-based programs (15.7% vs. 10.2%, Preward-based programs among the estimated 13.7% of the participants who would accept participation in either type of program. CONCLUSIONS Reward-based programs were much more commonly accepted than deposit-based programs, leading to higher rates of sustained abstinence from smoking. Group-oriented incentive programs were no more effective than individual-oriented programs. (Funded by the National Institutes of Health and CVS Caremark; ClinicalTrials.gov number, NCT01526265.) PMID:25970009

  7. Short-term effects of an educational program on health-seeking behavior for infections in patients with type 2 diabetes : a randomized controlled intervention trial in primary care

    NARCIS (Netherlands)

    Venmans, Leonie M A J; Gorter, Kees J; Hak, Eelko; Rutten, Guy E H M

    2008-01-01

    OBJECTIVE: The aim of this study was to assess the short-term effects of an educational program on (determinants of) self-reported health-seeking behavior for infections of the urinary tract (UTIs) and lower respiratory tract (LRTIs) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: In

  8. Short-term effects of an educational program on health-seeking behavior for infections in patients with type 2 diabetes : a randomized controlled intervention trial in primary care

    NARCIS (Netherlands)

    Venmans, Leonie M A J; Gorter, Kees J; Hak, Eelko; Rutten, Guy E H M

    OBJECTIVE: The aim of this study was to assess the short-term effects of an educational program on (determinants of) self-reported health-seeking behavior for infections of the urinary tract (UTIs) and lower respiratory tract (LRTIs) in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: In

  9. Global health training in pediatric residency programs.

    Science.gov (United States)

    Nelson, Brett D; Lee, Anne Cc; Newby, P K; Chamberlin, M Robert; Huang, Chi-Cheng

    2008-07-01

    Our goal was to describe current resident interest, participation, curricula, resources, and obstacles related to global health training within pediatric residency programs. We conducted a cross-sectional survey of the 201 accredited pediatric residency programs in the United States, Puerto Rico, and the Caribbean from October 2006 to January 2007. Survey topics included resident interest and participation in electives, training opportunities, program support, and educational curricular content related to global health. Of the 201 surveyed pediatric residency programs, 106 (53%) responded. Fifteen percent of responding programs reported that a majority of their residents were interested in global health. Fifty-two percent offered a global health elective within the previous year, and 47% had formally incorporated global health into their training curricula. Six percent of the programs reported a formalized track or certificate in global health. The median number of residents per program participating in global health electives within the previous year was 0 during postgraduate year 1, 1 during postgraduate year 2, and 2 during postgraduate year 3. The median number of all residents per program participating in a global health elective in the previous year was 3 (7.4% of program size). Among programs that offered a global health elective, support to participating residents included prerequisite clinical training (36%), cultural orientation (36%), language training (15%), faculty mentorship (82%), and post-elective debriefing (77%). Fourteen percent of the programs provided full funding for resident electives. Characteristics of pediatric residency programs that were significantly associated with higher resident participation in a global health elective were larger program size, university affiliation, greater reported resident interest, and faculty involvement in global health. More than half of the pediatric residency programs surveyed offered a global health

  10. Components of effective randomized controlled trials of hydrotherapy programs for fibromyalgia syndrome: A systematic review

    Directory of Open Access Journals (Sweden)

    Luke Perraton

    2009-11-01

    Full Text Available Luke Perraton, Zuzana Machotka, Saravana KumarInternational Centre for Allied Health Evidence, University of South Australia, Adelaide, South Australia, AustraliaAim: Previous systematic reviews have found hydrotherapy to be an effective management strategy for fibromyalgia syndrome (FMS. The aim of this systematic review was to summarize the components of hydrotherapy programs used in randomized controlled trials.Method: A systematic review of randomized controlled trials was conducted. Only trials that have reported significant FMS-related outcomes were included. Data relating to the components of hydrotherapy programs (exercise type, duration, frequency and intensity, environmental factors, and service delivery were analyzed.Results: Eleven randomized controlled trials were included in this review. Overall, the quality of trials was good. Aerobic exercise featured in all 11 trials and the majority of hydrotherapy programs included either a strengthening or flexibility component. Great variability was noted in both the environmental components of hydrotherapy programs and service delivery.Conclusions: Aerobic exercise, warm up and cool-down periods and relaxation exercises are common features of hydrotherapy programs that report significant FMS-related outcomes. Treatment duration of 60 minutes, frequency of three sessions per week and an intensity equivalent to 60%–80% maximum heart rate were the most commonly reported exercise components. Exercise appears to be the most important component of an effective hydrotherapy program for FMS, particularly when considering mental health-related outcomes.Keywords: hydrotherapy, fibromyalgia syndrome, exercise, effective, components

  11. 75 FR 48815 - Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to the Medicaid...

    Science.gov (United States)

    2010-08-11

    ... Medicaid Program and Children's Health Insurance Program (CHIP); Revisions to the Medicaid Eligibility... Program and Children's Health Insurance Program (CHIP); Revisions to the Medicaid Eligibility Quality... Children's Health Insurance Program (CHIP). DATES: Effective Date: These regulations are effective on...

  12. Effects of television programs about Family Health

    Directory of Open Access Journals (Sweden)

    Vagner Ferreira do Nascimento

    2012-09-01

    Full Text Available This is an observational study, which sought to reflect on the impact of television programs on family health. Thus, from February to July 2011, a Family Health Unit of Barra do Garças - Mato Grosso, the researcher observed the behavior of customers, through spontaneous expressions which referred to the materials or articles about health programs. At the end of the study, it wasfound that such programs stimulated and generated new behaviors, especially in women. But to do so, health professionals must engage with this media education and participate in the conduct of learned information in accordance with the need of the viewer.

  13. [RAN: A computer program to estimate random response patterns in objective tests Computar program for random response].

    Science.gov (United States)

    Merino Soto, César; López Pina, José

    2010-05-01

    In the psychological measurement, especially in personality, the paper-pencil method is the usual device between the psychologist and allied professions. The score obtained by a person examined can have questionable validity if the responses were random. To identify this problem, different methods have been used. The random response is a challenging situation for the measurement research and diagnosis in cognitive performance and personality, when they have been measured by test of dichotomous type. In this study a computer program that implements the Charter's method of point estimate and confidence intervals is presented in order to identify if the score obtained can be considered random. We analyze and discuss this program uses in the research and professional practice.

  14. Country prototypes and translation of health programs.

    Science.gov (United States)

    Sussman, Steve; Unger, Jennifer B; Palinkas, Lawrence A

    2008-06-01

    This article introduces the topic of international translation of health programs. Different perspectives toward the study of national-level variables that are relevant to translation of evidence-based programming developed outside of or in a country are discussed. Concepts including national prototypes, national stereotypes, country clusters, knowledge incompatibility, and absorptive capacity are introduced. The ideas expressed in this article serve to provide direction when considering developing a health behavior program for a country, using previous programmatic knowledge from elsewhere.

  15. Effectiveness of the Complete Health Improvement Program

    Science.gov (United States)

    Hutchins, Mathew; Melancon, Jim; Sneed, Demarcus; Nunning, Jennifer

    2015-01-01

    Currently, heart disease and diabetes dominate society as the leading cause of death for Americans. In this study, we examined the effectiveness of a lifestyle enhancement program on factors related to the development of heart disease. The Wabash Valley Complete Health Improvement Program (CHIP) is a community-based lifestyle change program with…

  16. Prevalence of health promotion programs in primary health care units in Brazil

    Science.gov (United States)

    Ramos, Luiz Roberto; Malta, Deborah Carvalho; Gomes, Grace Angélica de Oliveira; Bracco, Mário M; Florindo, Alex Antonio; Mielke, Gregore Iven; Parra, Diana C; Lobelo, Felipe; Simoes, Eduardo J; Hallal, Pedro Curi

    2014-01-01

    OBJECTIVE Assessment of prevalence of health promotion programs in primary health care units within Brazil’s health system. METHODS We conducted a cross-sectional descriptive study based on telephone interviews with managers of primary care units. Of a total 42,486 primary health care units listed in the Brazilian Unified Health System directory, 1,600 were randomly selected. Care units from all five Brazilian macroregions were selected proportionally to the number of units in each region. We examined whether any of the following five different types of health promotion programs was available: physical activity; smoking cessation; cessation of alcohol and illicit drug use; healthy eating; and healthy environment. Information was collected on the kinds of activities offered and the status of implementation of the Family Health Strategy at the units. RESULTS Most units (62.0%) reported having in place three health promotion programs or more and only 3.0% reported having none. Healthy environment (77.0%) and healthy eating (72.0%) programs were the most widely available; smoking and alcohol use cessation were reported in 54.0% and 42.0% of the units. Physical activity programs were offered in less than 40.0% of the units and their availability varied greatly nationwide, from 51.0% in the Southeast to as low as 21.0% in the North. The Family Health Strategy was implemented in most units (61.0%); however, they did not offer more health promotion programs than others did. CONCLUSIONS Our study showed that most primary care units have in place health promotion programs. Public policies are needed to strengthen primary care services and improve training of health providers to meet the goals of the agenda for health promotion in Brazil. PMID:25372175

  17. Automatic Probabilistic Program Verification through Random Variable Abstraction

    CERN Document Server

    Barsotti, Damián; 10.4204/EPTCS.28.3

    2010-01-01

    The weakest pre-expectation calculus has been proved to be a mature theory to analyze quantitative properties of probabilistic and nondeterministic programs. We present an automatic method for proving quantitative linear properties on any denumerable state space using iterative backwards fixed point calculation in the general framework of abstract interpretation. In order to accomplish this task we present the technique of random variable abstraction (RVA) and we also postulate a sufficient condition to achieve exact fixed point computation in the abstract domain. The feasibility of our approach is shown with two examples, one obtaining the expected running time of a probabilistic program, and the other the expected gain of a gambling strategy. Our method works on general guarded probabilistic and nondeterministic transition systems instead of plain pGCL programs, allowing us to easily model a wide range of systems including distributed ones and unstructured programs. We present the operational and weakest pr...

  18. 78 FR 42159 - Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative...

    Science.gov (United States)

    2013-07-15

    ... Children's Health Insurance Programs: Essential Health Benefits in Alternative Benefit Plans, Eligibility...-AR04 Medicaid and Children's Health Insurance Programs: Essential Health Benefits in Alternative... to electronic Medicaid and the Children's Health Insurance Program (CHIP) eligibility notices and...

  19. Result of randomized control trial to increase breast health awareness among young females in Malaysia.

    Science.gov (United States)

    Akhtari-Zavare, Mehrnoosh; Juni, Muhamad Hanafiah; Said, Salmiah Md; Ismail, Irmi Zarina; Latiff, Latiffah A; Ataollahi Eshkoor, Sima

    2016-08-08

    Breast cancer is the most common cancer and the second principal cause of cancer deaths in women worldwide as well as in Malaysia. Breast self-examination (BSE) has a role in raising breast cancer awareness among women and educational programs play an important role in breast cancer preventive behavior. The aim of this study is to develop, implement and evaluate the effectiveness of Breast Health Awareness program based on health belief model on knowledge of breast cancer and breast-selfexamination and BSE practice among female students in Malaysia. A single-blind randomized controlled trial was carried out among 370 female undergraduate students from January 2011 to April 2012 in two selected public universities in Malaysia. Participants were randomized to either the intervention group or the control group. The educational program was delivered to the intervention group. The outcome measures were assessed at baseline, 6, and 12 months after implementing the health educational program. Chi-square, independent samples t-test and two-way repeated measures ANOVA (GLM) were conducted in the course of the data analyses. Mean scores of knowledge on breast cancer (pknowledge on breast self examination (pBreast Health Awareness program based on health the belief model had a positive effect on knowledge of breast cancer and breast self-examination and practice of BSE among females in Malaysia. The ANZCTR clinical trial registry ( ACTRN12616000831482 ), retrospectively registered on Jun 23, 2016 in ANZCTR.org.au.

  20. IMIA Accreditation of Health Informatics Programs.

    Science.gov (United States)

    Hasman, A

    2012-01-01

    To develop a procedure for accrediting health informatics programs. Development of a procedure for accreditation. Test of the accreditation procedure via a trial including four or five health informatics programs. A site visit committee consisting of three members evaluates the program based on a self-assessment report written by the program and the experiences and observations of the site visit committee during the site visit. A procedure for accreditation has been developed. The instructions for health informatics programs have been written and a checklist for the site visit committee members is available. In total six subjects are considered, each one consisting of one or more facets. Each facet is judged using its corresponding criterion. Five health informatics programs volunteered. One health informatics program in Finland has already been visited and a report has been produced by the site visit committee. The next site visits are in June and July 2012. The site visit in Finland showed that English summaries of master theses are not enough to get a first impression of the methods used in the thesis. A table of contents is also needed. This information then can be used to select theses written in a language other than English for discussion. The accreditation procedure document with instructions about writing the self-assessment report was very well structured and the instructions were clear according to the Finnish program. The site visit team could work well with the checklist. Self-assessment report model was very well structured and the instructions were clear.

  1. 75 FR 81885 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Correcting Amendment

    Science.gov (United States)

    2010-12-29

    ... Programs; Electronic Health Record Incentive Program; Correcting Amendment AGENCY: Centers for Medicare...; Electronic Health Record Incentive Program'' that appeared in the July 28, 2010 Federal Register. DATES... 44314) the final rule entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive...

  2. EFFECTS OF FOOD ASSISTANCE AND NUTRITION PROGRAMS ON NUTRITION AND HEALTH, VOLUME 1, RESEARCH DESIGN

    OpenAIRE

    Hamilton, William L.; Rossi, Peter H.

    2002-01-01

    This is the first of four reports in the "Nutrition and Health Outcome Study," which assesses the effects of USDA's food assistance and nutrition programs on nutrition and health outcomes. This report reviews the research designs available to evaluators for assessing the effect of USDA's food assistance and nutrition programs. The random assignment experiment is the "gold standard" design for such an evaluation. Where random assignment is impossible, quasi-experimental designs are used to inf...

  3. 78 FR 54256 - Health Careers Opportunity Program

    Science.gov (United States)

    2013-09-03

    ... focus could be formed through collaboration with a Behavioral Health Department/School or Program that... University of MI 111,764 Michigan-Flint. D18HP10627 Mount Sinai NY 111,764 School of Medicine. D18HP23032... primarily focused on exposure to careers in medicine, dentistry, pharmacy, and allied health. With the...

  4. THE SCHOOL HEALTH AND SAFETY PROGRAM.

    Science.gov (United States)

    1963

    INVOLVING INDIVIDUALS AS WELL AS ORGANIZATIONS, THE PROGRAM AIMED AT THE OPTIMUM HEALTH OF ALL CHILDREN, AND IMPROVEMENT OF HEALTH AND SAFETY STANDARDS WITHIN THE COMMUNITY. EACH OF THE CHILDREN WAS URGED TO HAVE A SUCCESSFUL VACCINATION FOR SMALL POX, THE DPT SERIES AND BOOSTER, THE POLIO SERIES, AND CORRECTIONS OF ALL DENTAL DEFECTS AND…

  5. Rationale and design of a cluster-randomized controlled trial to evaluate the effects of a community health worker-based program for cardiovascular risk factor control in India.

    Science.gov (United States)

    Khetan, Aditya; Purushothaman, Raghunandan; Zullo, Melissa; Gupta, Rishab; Hejjaji, Vittal; Agarwal, Sushil; Mohan, Sri Krishna Madan; Josephson, Richard

    2017-03-01

    The increasing burden of cardiovascular disease (CVD) in low- and middle-income countries is largely driven by the increasing prevalence of hypertension, diabetes, and tobacco use. We hypothesize that the utilization of community health workers (CHWs) to screen for and manage these 3 determinants of CVD in an integrated manner would be an effective approach to favorably affecting public health. We have designed and set up the infrastructure to implement a 2-year community-based cluster randomized controlled trial in an underserved region of West Bengal, India. Participants include around 1200 adults, aged between 35 and 70 years, with ≥1 cardiovascular risk factor. They are recruited through home-based screening into a total of 12 clusters, which are randomized to either a control or intervention arm before screening. After the screening, CHWs follow up with participants enrolled in the intervention arm for a period of 2 years through home visits. The control arm receives usual care in the community. The CHW arm follows a behavioral strategy focused on modifying the individual's lifestyle, increasing knowledge of CVD, promoting smoking cessation, increasing physician-seeking behavior, and promoting medication adherence. The main project office is based in Cleveland, OH, at University Hospitals/CWRU, and the local site office is located in Dalkhola, West Bengal, at a local nonprofit set up for the study. Institutional review board approval was obtained both in Cleveland as well as in India. The 2-year primary outcome of the study is the absolute reduction in systolic blood pressure among hypertensive participants, absolute reduction in fasting blood glucose among diabetic participants, and absolute reduction in average number of cigarettes smoked per day among smokers. We believe that this study infrastructure serves as a useful model for international collaboration. It builds on unique local resources, attends to important domestic requirements, and will

  6. Health Literacy and Weight Change in a Digital Health Intervention for Women: A Randomized Controlled Trial in Primary Care Practice

    Science.gov (United States)

    Lanpher, Michele G.; Askew, Sandy; Bennett, Gary G.

    2016-01-01

    In the U.S., 90 million adults have low health literacy. An important public health challenge is developing obesity treatment interventions suitable for those with low health literacy. The objective of this study was to examine differences in sociodemographic and clinical characteristics, as well as weight and intervention engagement outcomes by health literacy. We randomized 194 participants to usual care or to the Shape Program intervention, a 12 month digital health treatment aimed to prevent weight gain among overweight and class I obese black women in primary care practice. We administered the Newest Vital Sign instrument to assess health literacy. Over half (55%)of participants had low health literacy, which was more common for those with fewer years of educational attainment and lower income. There was no effect of health literacy on 12-month weight change or on intervention engagement outcomes (completion of coaching calls and interactive voice response self-monitoring calls). Low health literacy did not preclude successful weight gain prevention in the Shape Program intervention. Goal focused behavior change approaches like that used in Shape may be particularly helpful for treating and engaging populations with low health literacy. PMID:27043756

  7. Health Literacy and Weight Change in a Digital Health Intervention for Women: A Randomized Controlled Trial in Primary Care Practice.

    Science.gov (United States)

    Lanpher, Michele G; Askew, Sandy; Bennett, Gary G

    2016-01-01

    In the United States, 90 million adults have low health literacy. An important public health challenge is developing obesity treatment interventions suitable for those with low health literacy. The objective of this study was to examine differences in sociodemographic and clinical characteristics as well as weight and intervention engagement outcomes by health literacy. We randomized 194 participants to usual care or to the Shape Program intervention, a 12-month digital health treatment aimed at preventing weight gain among overweight and Class I obese Black women in primary care practice. We administered the Newest Vital Sign instrument to assess health literacy. More than half (55%) of participants had low health literacy, which was more common among those with fewer years of education and lower income. There was no effect of health literacy on 12-month weight change or on intervention engagement outcomes (completion of coaching calls and interactive voice response self-monitoring calls). Low health literacy did not preclude successful weight gain prevention in the Shape Program intervention. Goal-focused behavior change approaches like that used in Shape may be particularly helpful for treating and engaging populations with low health literacy.

  8. Automatic Probabilistic Program Verification through Random Variable Abstraction

    Directory of Open Access Journals (Sweden)

    Damián Barsotti

    2010-06-01

    Full Text Available The weakest pre-expectation calculus has been proved to be a mature theory to analyze quantitative properties of probabilistic and nondeterministic programs. We present an automatic method for proving quantitative linear properties on any denumerable state space using iterative backwards fixed point calculation in the general framework of abstract interpretation. In order to accomplish this task we present the technique of random variable abstraction (RVA and we also postulate a sufficient condition to achieve exact fixed point computation in the abstract domain. The feasibility of our approach is shown with two examples, one obtaining the expected running time of a probabilistic program, and the other the expected gain of a gambling strategy. Our method works on general guarded probabilistic and nondeterministic transition systems instead of plain pGCL programs, allowing us to easily model a wide range of systems including distributed ones and unstructured programs. We present the operational and weakest precondition semantics for this programs and prove its equivalence.

  9. Health education for microcredit clients in Peru: a randomized controlled trial.

    Science.gov (United States)

    Hamad, Rita; Fernald, Lia Ch; Karlan, Dean S

    2011-01-24

    Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization's Integrated Management of Childhood Illness (IMCI) community intervention. Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855) and their children (n = 598). Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization's loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels). To explore the effects of treatment (i.e., participation in the health education sessions) on the key outcome variables, multivariate regressions were implemented using ordinary least squares. Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status. Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply that the intervention did not have sufficient intensity to change

  10. Dose-response effects of a Web-based physical activity program on body composition and metabolic health in inactive older adults: additional analyses of a randomized controlled trial.

    Science.gov (United States)

    Vroege, David P; Wijsman, Carolien A; Broekhuizen, Karen; de Craen, Anton J M; van Heemst, Diana; van der Ouderaa, Frans J G; van Mechelen, Willem; Slagboom, P Eline; Catt, Michael; Westendorp, Rudi G J; Verhagen, Evert A L M; Mooijaart, Simon P

    2014-12-04

    Low physical activity is a major risk factor for several age-related diseases. Recently, we showed in a randomized controlled trial that a 12-week Web-based intervention (Philips DirectLife) to increase physical activity was effective in increasing physical activity levels and metabolic health in an inactive population aged 60-70 years. The goal of this paper was to assess how many participants successfully reached the physical activity level as targeted by the intervention and what the effects of the intervention on body composition and metabolic health in these successful individuals were to provide insight in the maximum attainable effect of the intervention. Among the 235 participants in a randomized controlled trial of the Actief en Gezond Oud (AGO) study, we assessed the effects of the intervention on metabolic parameters in those who had successfully reached their personalized physical activity target compared with the entire intervention group. Furthermore, we studied the dose-response effect of increase in physical activity on metabolic outcome within the intervention group. Of the intervention group, 50 of 119 (42.0%) participants successfully reached the physical activity target (corresponding to a 10% increased daily physical activity on average). This group showed markedly higher effects of the intervention compared to the entire intervention group, with greater decreases in body weight (2.74 vs 1.49 kg), waist circumference (3.74 vs 2.33 cm), insulin resistance (HOMA index: 0.23 vs 0.20), and in cholesterol/HDL ratio (0.39 vs 0.20) and Framingham risk score (0.90% vs 0.54%). We found that men compared to women were more likely to be successful. The dose-response analysis showed that there was a significant association between increase in minutes spent in moderate-to-vigorous activity and body weight loss, BMI reduction, waist circumference reduction, HDL cholesterol increasing, and cholesterol/HDL ratio lowering. Of the intervention group, 42.0% (50

  11. Using convex quadratic programming to model random media with Gaussian random fields

    Science.gov (United States)

    Quintanilla, John A.; Jones, W. Max

    2007-04-01

    Excursion sets of Gaussian random fields (GRFs) have been frequently used in the literature to model two-phase random media with measurable phase autocorrelation functions. The goal of successful modeling is finding the optimal field autocorrelation function that best approximates the prescribed phase autocorrelation function. In this paper, we present a technique which uses convex quadratic programming to find the best admissible field autocorrelation function under a prescribed discretization. Unlike previous methods, this technique efficiently optimizes over all admissible field autocorrelation functions, instead of optimizing only over a predetermined parametrized family. The results from using this technique indicate that the GRF model is significantly more versatile than observed in previous studies. An application to modeling a base-catalyzed tetraethoxysilane aerogel system given small-angle neutron scattering data is also presented

  12. A school-based physical activity program to improve health and fitness in children aged 6–13 years ("Kinder-Sportstudie KISS": study design of a randomized controlled trial [ISRCTN15360785

    Directory of Open Access Journals (Sweden)

    Knöpfli Martin

    2006-06-01

    Full Text Available Abstract Background Childhood obesity is the result of a long lasting imbalance between energy intake and energy expenditure. A major contributing factor is physical inactivity which is closely linked to bone health, cardiovascular disease risk, fitness and psychological factors. The school seems to provide an excellent setting to enhance levels of physical activity (PA. However, there is insufficient data from previous school-based intervention trials on how to enhance overall PA. It is also unknown whether an intervention aimed at increasing PA is effective in improving the children's health. The purpose of this paper is to outline the design of a school-based randomized, controlled trial (RCT aiming to increase overall PA and to improve fitness and health in 6- to 13-year-old children. Methods/Design 15 schools were randomized to the intervention (n = 9 or the control (n = 6 group, stratified by geographic region (urban vs. rural and by age (1st and 5th grade. Participation was given for all children in the intervention group since in this group the intervention was part of the normal school curriculum. The intervention during one academic year consisted of: 1. two additional physical education classes per week given by trained physical education teachers adding up to a total of five PA classes per week, 2. short PA breaks (2–5 min each during academic lessons, 3. PA home work, and 4. adaptation of recreational areas around the school. All children underwent anthropometric measurements, blood pressure assessment, fitness testing, measurement of PA and they filled out questionnaires. At least 70% of all children agreed to blood sampling and measurements of body composition and bone mineral measurements by dual energy x-ray absorptiometry. The primary endpoints of the study after one year were an increase in total PA by accelerometry, an increase in aerobic fitness measured by the 20 m shuttle run, a decrease in percent body fat derived from

  13. Investigating the Effect of Implementing the School Based Health Promotion Program on Students’ Mental Health

    Directory of Open Access Journals (Sweden)

    Abdollatif Esmaeili

    2011-01-01

    Full Text Available Introduction: The “school- based health program” is implemented in schools all over the country with the purpose of preventing substance abuse, high-risk behaviors, and violence. The current study aimed at evaluating the effectiveness of this program in enhancing some of the health indicators of the students participating in this program. Methods: In this cross- sectional study, based on the Krejcie and Morgan table, 400 students (4 groups- 2cases and 2 controls- each including 100 people from both male and female genders were selected through stratified and stage random sampling. The data gathering tools were the “General Health Questionnaire”, Rosenberg Self Esteem Inventory, Oxford Happiness Questionnaire, Satisfied with Life Scale. The data were analyzed using SPSS 13 software and through descriptive statistics and paired t test. Results: There were no statistically significant differences between General Health, Self esteem, Happiness and Satisfied with Life mean scores of case and control groups. However, the differences between the mean scores of the two groups in educational performance were significant (P=0.005. Conclusion: General findings of this study indicate that education presented to students via school-based health program has not been effective in enhancing their mental health. Therefore, to improve the effectiveness of this program, it is suggested that the educational methods of this program be revised.

  14. Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial*

    OpenAIRE

    Slade, Gary D.; Bailie, Ross S; Roberts-Thomson, Kaye; Leach, Amanda J; Raye, Iris; Endean, Colin; Simmons, Bruce; Morris, Peter

    2011-01-01

    Objectives We tested a dental health program in remote Aboriginal communities of Australia's Northern Territory, hypothesizing that it would reduce dental caries in preschool children. Methods In this 2-year, prospective, cluster-randomized, concurrent controlled, open trial of the dental health program compared to no such program, 30 communities were allocated at random to intervention and control groups. All residents aged 18–47 months were invited to participate. Twice per year for 2 years...

  15. Program management of telemental health care services.

    Science.gov (United States)

    Darkins, A

    2001-01-01

    Telemedicine is a new adjunct to the delivery of health care services that has been applied to a range of health care specialties, including mental health. When prospective telemedicine programs are planned, telemedicine is often envisaged as simply a question of introducing new technology. The development of a robust, sustainable telemental health program involves clinical, technical, and managerial considerations. The major barriers to making this happen are usually how practitioners and patients adapt successfully to the technology and not in the physical installation of telecommunications bandwidth and the associated hardware necessary for teleconsultation. This article outlines the requirements for establishing a viable telemental health service, one that is based on clinical need, practitioner acceptance, technical reliability, and revenue generation. It concludes that the major challenge associated with the implementation of telemental health does not lie in having the idea or in taking the idea to the project stage needed for proof of concept. The major challenge to the widespread adoption of telemental health is paying sufficient attention to the myriad of details needed to integrate models of remote health care delivery into the wider health care system.

  16. Attendance at Health Promotion Programs: Baseline Predictors and Program Outcomes.

    Science.gov (United States)

    Atkins, Catherine J.; And Others

    1990-01-01

    As part of a family cardiovascular health promotion project, 111 Mexican-American and 95 Anglo-American families with fifth or sixth grade children were assigned to either a primary prevention program involving 18 sessions or to a control condition. Correlates of attendance were low baseline scores on physical activity and cardiovascular fitness…

  17. Can health promotion programs save Medicare money?

    Science.gov (United States)

    Goetzel, Ron Z; Shechter, David; Ozminkowski, Ronald J; Stapleton, David C; Lapin, Pauline J; McGinnis, J Michael; Gordon, Catherine R; Breslow, Lester

    2007-01-01

    The impact of an aging population on escalating US healthcare costs is influenced largely by the prevalence of chronic disease in this population. Consequently, preventing or postponing disease onset among the elderly has become a crucial public health issue. Fortunately, much of the total burden of disease is attributable to conditions that are preventable. In this paper, we address whether well-designed health promotion programs can prevent illness, reduce disability, and improve the quality of life. Furthermore, we assess evidence that these programs have the potential to reduce healthcare utilization and related expenditures for the Medicare program. We hypothesize that seniors who reduce their modifiable health risks can forestall disability, reduce healthcare utilization, and save Medicare money. We end with a discussion of a new Senior Risk Reduction Demonstration, which will be initiated by the Centers for Medicare and Medicaid Services in 2007, to test whether risk reduction programs developed in the private sector can achieve health improvements among seniors and a positive return on investment for the Medicare program. PMID:18044084

  18. Training program attracts work and health researchers

    DEFF Research Database (Denmark)

    Skakon, Janne

    2007-01-01

    Each year in Canada, the costs of disability arising from work-related causes – including workers’ compensation and health-care costs – exceed $6.7 billion. Despite the significant financial and social impacts of worker injury and illness, only a small fraction of Canadian researchers are dedicated...... to examining work disability prevention issues. An innovative program that attracts international students, the Work Disability Prevention Canadian Institutes of Health Research (CIHR) Strategic Training Program, aims to build research capacity in young researchers and to create a strong network that examines...

  19. [Chuzhen therapy for sub-health: a randomized controlled study].

    Science.gov (United States)

    Hu, You-Ping; Xu, Zhen-Jie; Wu, Jia; Xing, Lin; Zhang, Lei-Xiao; Zhang, Jin-Xing; Tan, Hui; Mao, Shi-Zhi; Zhou, Cong-Quan

    2012-11-01

    To observe the effect on intervention of sub-health with pestle needle (Chuzhen). Randomized controlled trail was adopted for this research. One hundred and fifty-three cases were randomly divided into two groups of a Chuzhen group (79 cases) and a massage group (74 cases). Acupoint of Bazhen (Baihui Bazhen, Shendao Bazhen, Zhiyang Bazhen, Mingmen Bazhen, Yaoyangguan Bazhen), Hechelu on the head, the neck and the lumbar area were adopted in Chuzhen group. While regular whole-body massage was applied in the massage group. The human sub-health score, the cornell medical index (CMI) and thermal texture maps system (TTM) technology of the two groups before and after the intervention were observed. 1) After treatment, sub-health condition score, the CMI score, the M-R score and the TTM index were all increased in both groups (all P0.05). 3) The sub-health condition score in Chuzhen group was higher than that in the massage group (P<0.01). Chuzhen therapy has definite effect on intervention of sub-health, which is better than regular general massage.

  20. 77 FR 23193 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2; Corrections

    Science.gov (United States)

    2012-04-18

    ... Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage 2; Corrections AGENCY... Medicaid Programs; Electronic Health Record Incentive Program--Stage 2'' which appeared in the March 7... ``Medicare and Medicaid Programs; Electronic Health Record Incentive Program--Stage 2'' there were a number...

  1. A Randomized Clinical Trial of a Web-Based Tobacco Cessation Education Program

    Science.gov (United States)

    Mahabee-Gittens, E. Melinda; Andrews, Judy A.; Christiansen, Steven M.; Byron, David J.

    2013-01-01

    OBJECTIVES: We report the results of a randomized clinical trial of a 3-hour, web-based, tobacco cessation education program, the Web-Based Respiratory Education About Tobacco and Health (WeBREATHe) program, for practicing pediatric respiratory therapists (RTs), registered nurses (RNs), and nurse practitioners (NPs). METHODS: Two hundred fifteen RTs (n = 40), RNs (n = 163), and NPs (n = 12) employed at the Children’s Hospital of Philadelphia and the Children’s Hospital, University of Colorado at Denver, participated in this study. All study activities were completed online. After consenting, participants were randomly assigned to either the training (intervention) or delayed training (control) condition. The training condition consisted of a 3-hour continuing education unit course plus ongoing online resources. Participants were assessed at baseline, 1 week, and 3 months after enrollment. RESULTS: Participants in the training condition were more likely to increase their tobacco cessation intervention behaviors than their delayed training counterparts (F[1, 213] = 32.03, P < .001). Training participants showed significantly greater levels of advise (F[1, 213] = 7.22, P < .001); assess (F[1, 213] = 19.56, P < .001); and particularly assist/arrange (F[1213] = 35.52, P < .001). In addition, training condition participants rated the program highly on measures of consumer satisfaction. CONCLUSIONS: The WeBREATHe program is the first evidence-based education program in tobacco cessation designed specifically for pediatric RTs, RNs, and NPs. Engagement in WeBREATHe increased participants’ tobacco cessation-related behaviors. PMID:23319529

  2. 76 FR 4350 - Health Information Technology Extension Program

    Science.gov (United States)

    2011-01-25

    ... HUMAN SERVICES Health Information Technology Extension Program ACTION: Public Notice. SUMMARY: This notice announces changes to the Health Information Technology Extension Program, which assists providers seeking to adopt and become meaningful users of health information technology, as authorized under...

  3. Estimates of Intraclass Correlation Coefficients from Longitudinal Group-Randomized Trials of Adolescent HIV/STI/Pregnancy Prevention Programs

    Science.gov (United States)

    Glassman, Jill R.; Potter, Susan C.; Baumler, Elizabeth R.; Coyle, Karin K.

    2015-01-01

    Introduction: Group-randomized trials (GRTs) are one of the most rigorous methods for evaluating the effectiveness of group-based health risk prevention programs. Efficiently designing GRTs with a sample size that is sufficient for meeting the trial's power and precision goals while not wasting resources exceeding them requires estimates of the…

  4. Prevention Programs for Refugee Mental Health.

    Science.gov (United States)

    Williams, Carolyn L.

    Refugee movements impose tremendous psychological and physical trauma on survivors, making refugees a high risk group for psychopathology and psychosocial adjustment problems. This paper explores the traditional impediments to developing prevention programs for refugees and describes public mental health strategies that could be used for different…

  5. Child health developmental plasticity, and epigenetic programming

    Science.gov (United States)

    Plasticity in developmental programming has evolved in order to provide the best chances of survival and reproductive success to the organism under changing environments. Environmental conditions that are experienced in early life can profoundly influence human biology and long-term health. Developm...

  6. School Oral Health Program in Kuwait.

    Science.gov (United States)

    Ariga, Jitendra; Al-Mutawa, Sabiha; Nazar, Huda

    2014-01-01

    The School Oral Health Program (SOHP), Kuwait, is a joint venture between the Ministry of Health, Kuwait, and Forsyth Institute, Cambridge, Mass., USA. This program provides oral health education, prevention and treatment to almost 280,000 public school children in Kuwait. Services are delivered through a system of center- and school-based clinics and preventive mobile teams. One of the recent developments is the effective use of portable dental units for the delivery of preventive care to children in schools without the need for children to go to dental clinics. Preventive procedures performed under this program are the biannual application of fluoride varnish and the placement of pit and fissure sealants on newly erupted permanent molars and premolars. During recent years, the SOHP has improved its coverage of children, with prevention up to 80%. This has resulted in a considerable reduction in treatment needs, which is evident from the reduced number of composite restorations performed under this program during the last 6 years. This indicates that the disease level is on a decline, which can be confirmed from the results of the ongoing National Oral Health Survey on Kuwaiti school children.

  7. Culturally Sensitive Refugee Mental Health Training Programs.

    Science.gov (United States)

    Minnesota Univ., Minneapolis. Refugees Assistance Program - Mental Health Technical Assistance Center.

    This report, based on a survey conducted during the summer and fall of 1986, identifies culturally sensitive training programs for professionals, paraprofessionals, and others who provide mental health services to refugees. An introductory section discusses the language, cultural, racial, experiential, and socioeconomic factors of refugee mental…

  8. Improving health-related fitness in children: the fit-4-Fun randomized controlled trial study protocol

    Directory of Open Access Journals (Sweden)

    Eather Narelle

    2011-12-01

    Full Text Available Abstract Background Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health. Physical activity programs for children that involve regular high intensity physical activity, along with muscle and bone strengthening activities, have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases. This paper reports the rationale and methods for a school-based intervention designed to improve physical fitness and physical activity levels of Grades 5 and 6 primary school children. Methods/Design Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group randomized controlled trial. Primary schools from the Hunter Region in NSW, Australia, will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children (age 10-13. The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework. Students will participate in weekly curriculum-based health and physical education lessons, daily break-time physical activities during recess and lunch, and will complete an 8-week (3 × per week home activity program with their parents and/or family members. A battery of six health-related fitness assessments, four days of pedometery-assessed physical activity and a questionnaire, will be administered at baseline, immediate post-intervention (2-months and at 6-months (from baseline to determine intervention effects. Details of the methodological aspects of recruitment, inclusion criteria, randomization, intervention program, assessments, process evaluation and statistical analyses are described. Discussion The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children. The program will

  9. Evaluation of Three Osteoporosis Prevention Programs for Young Women: Application of the Health Belief Model

    Science.gov (United States)

    Lein, Donald H.; Turner, Lori; Wilroy, Jereme

    2016-01-01

    Purpose: The purpose of this study was to evaluate the effectiveness of theory-based osteoporosis prevention programs on calcium and vitamin D intakes and osteoporosis health beliefs in young women. Methods: Women (N = 152) aged 19 to 25 years were randomly assigned to one of 3 groups: a brochure group (n = 51), a computer-tailored program group…

  10. The impact of the Indonesian health card program: a matching estimator approach.

    Science.gov (United States)

    Johar, Meliyanni

    2009-01-01

    This study evaluates the effectiveness of a pro-poor nation-wide health card program, which provides free basic health care at public health facilities in Indonesia. To quantify the effect of the program, it departs from the traditional regression-based approach in the literature. It employs propensity score matching to reduce the selection bias due to non-random health card distribution. The setting of the program and the richness of the data set support this strategy in providing accurate estimates of the program's effect on its recipients. The results indicate that, in general, the health card program only has limited impact on the consumption of primary health care by its recipients. This finding suggests the presence of other factors counteracting the generous demand incentive.

  11. Health systems challenges in cervical cancer prevention program in Malawi

    Directory of Open Access Journals (Sweden)

    Fresier C. Maseko

    2015-01-01

    Full Text Available Background: Cervical cancer remains the leading cause of cancer death among women in sub-Saharan Africa. In Malawi, very few women have undergone screening and the incidence of cervical cancer is on the increase as is the case in most developing countries. We aimed at exploring and documenting health system gaps responsible for the poor performance of the cervical cancer prevention program in Malawi. Design: The study was carried out in 14 randomly selected districts of the 29 districts of Malawi. All cervical cancer service providers in these districts were invited to participate. Two semi-structured questionnaires were used, one for the district cervical cancer coordinators and the other for the service providers. The themes of both questionnaires were based on World Health Organization (WHO health system frameworks. A checklist was also developed to audit medical supplies and equipment in the cervical cancer screening facilities. The two questionnaires together with the medical supplies and equipment checklist were piloted in Chikwawa district before being used as data collection tools in the study. Quantitative data were analyzed using STATA and qualitative in NVIVO. Results: Forty-one service providers from 21 health facilities and 9 district coordinators participated in the study. Our findings show numerous health system challenges mainly in areas of health workforce and essential medical products and technologies. Seven out of the 21 health facilities provided both screening and treatment. Results showed challenges in the management of the cervical cancer program at district level; inadequate service providers who are poorly supervised; lack of basic equipment and stock-outs of basic medical supplies in some health facilities; and inadequate funding of the program. In most of the health facilities, services providers were not aware of the policy which govern their work and that they did not have standards and guidelines for cervical

  12. Health systems challenges in cervical cancer prevention program in Malawi.

    Science.gov (United States)

    Maseko, Fresier C; Chirwa, Maureen L; Muula, Adamson S

    2015-01-01

    Cervical cancer remains the leading cause of cancer death among women in sub-Saharan Africa. In Malawi, very few women have undergone screening and the incidence of cervical cancer is on the increase as is the case in most developing countries. We aimed at exploring and documenting health system gaps responsible for the poor performance of the cervical cancer prevention program in Malawi. The study was carried out in 14 randomly selected districts of the 29 districts of Malawi. All cervical cancer service providers in these districts were invited to participate. Two semi-structured questionnaires were used, one for the district cervical cancer coordinators and the other for the service providers. The themes of both questionnaires were based on World Health Organization (WHO) health system frameworks. A checklist was also developed to audit medical supplies and equipment in the cervical cancer screening facilities. The two questionnaires together with the medical supplies and equipment checklist were piloted in Chikwawa district before being used as data collection tools in the study. Quantitative data were analyzed using STATA and qualitative in NVIVO. Forty-one service providers from 21 health facilities and 9 district coordinators participated in the study. Our findings show numerous health system challenges mainly in areas of health workforce and essential medical products and technologies. Seven out of the 21 health facilities provided both screening and treatment. RESULTS showed challenges in the management of the cervical cancer program at district level; inadequate service providers who are poorly supervised; lack of basic equipment and stock-outs of basic medical supplies in some health facilities; and inadequate funding of the program. In most of the health facilities, services providers were not aware of the policy which govern their work and that they did not have standards and guidelines for cervical cancer screening and treatment. Numerous health

  13. The efficacy of resiliency training programs: a systematic review and meta-analysis of randomized trials.

    Directory of Open Access Journals (Sweden)

    Aaron L Leppin

    Full Text Available Poor mental health places a burden on individuals and populations. Resilient persons are able to adapt to life's challenges and maintain high quality of life and function. Finding effective strategies to bolster resilience in individuals and populations is of interest to many stakeholders.To synthesize the evidence for resiliency training programs in improving mental health and capacity in 1 diverse adult populations and 2 persons with chronic diseases.Electronic databases, clinical trial registries, and bibliographies. We also contacted study authors and field experts.Randomized trials assessing the efficacy of any program intended to enhance resilience in adults and published after 1990. No restrictions were made based on outcome measured or comparator used.Reviewers worked independently and in duplicate to extract study characteristics and data. These were confirmed with authors. We conducted a random effects meta-analysis on available data and tested for interaction in planned subgroups.The standardized mean difference (SMD effect of resiliency training programs on 1 resilience/hardiness, 2 quality of life/well-being, 3 self-efficacy/activation, 4 depression, 5 stress, and 6 anxiety.We found 25 small trials at moderate to high risk of bias. Interventions varied in format and theoretical approach. Random effects meta-analysis showed a moderate effect of generalized stress-directed programs on enhancing resilience [pooled SMD 0.37 (95% CI 0.18, 0.57 p = .0002; I2 = 41%] within 3 months of follow up. Improvement in other outcomes was favorable to the interventions and reached statistical significance after removing two studies at high risk of bias. Trauma-induced stress-directed programs significantly improved stress [-0.53 (-1.04, -0.03 p = .03; I2 = 73%] and depression [-0.51 (-0.92, -0.10 p = .04; I2 = 61%].We found evidence warranting low confidence that resiliency training programs have a small to moderate effect at

  14. 77 FR 37415 - Office of Urban Indian Health Programs; Title V HIV/AIDS Program

    Science.gov (United States)

    2012-06-21

    ... HUMAN SERVICES Indian Health Service Office of Urban Indian Health Programs; Title V HIV/AIDS Program... applications for the Office of Urban Indian Health Programs Title V HIV/AIDS program. This program is... The Minority AIDS Initiative funding that the grants are awarded from was awarded to the...

  15. 75 FR 1843 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Science.gov (United States)

    2010-01-13

    ... Medicaid Programs; Electronic Health Record Incentive Program; Proposed Rule #0;#0;Federal Register / Vol... Medicare and Medicaid Programs; Electronic Health Record Incentive Program AGENCY: Centers for Medicare... Medicaid programs that adopt and meaningfully use certified electronic health record (EHR) technology. The...

  16. A prospective randomized trial examining health care utilization in individuals using multiple smartphone-enabled biosensors

    Directory of Open Access Journals (Sweden)

    Cinnamon S. Bloss

    2016-01-01

    Full Text Available Background. Mobile health and digital medicine technologies are becoming increasingly used by individuals with common, chronic diseases to monitor their health. Numerous devices, sensors, and apps are available to patients and consumers–some of which have been shown to lead to improved health management and health outcomes. However, no randomized controlled trials have been conducted which examine health care costs, and most have failed to provide study participants with a truly comprehensive monitoring system. Methods. We conducted a prospective randomized controlled trial of adults who had submitted a 2012 health insurance claim associated with hypertension, diabetes, and/or cardiac arrhythmia. The intervention involved receipt of one or more mobile devices that corresponded to their condition(s (hypertension: Withings Blood Pressure Monitor; diabetes: Sanofi iBGStar Blood Glucose Meter; arrhythmia: AliveCor Mobile ECG and an iPhone with linked tracking applications for a period of 6 months; the control group received a standard disease management program. Moreover, intervention study participants received access to an online health management system which provided participants detailed device tracking information over the course of the study. This was a monitoring system designed by leveraging collaborations with device manufacturers, a connected health leader, health care provider, and employee wellness program–making it both unique and inclusive. We hypothesized that health resource utilization with respect to health insurance claims may be influenced by the monitoring intervention. We also examined health-self management. Results & Conclusions. There was little evidence of differences in health care costs or utilization as a result of the intervention. Furthermore, we found evidence that the control and intervention groups were equivalent with respect to most health care utilization outcomes. This result suggests there are not large

  17. 77 FR 62243 - Rural Health Network Development Program

    Science.gov (United States)

    2012-10-12

    ... Administration Rural Health Network Development Program AGENCY: Health Resources and Services Administration...-competitive replacement award under the Rural Health Network Development Program to the Siloam Springs... through the Rural Health Network Development Grant Program are to improve the capacity of network...

  18. Evaluation of a women group led health communication program in Haryana, India.

    Science.gov (United States)

    Kaur, Manmeet; Jaswal, Nidhi; Saddi, Anil Kumar

    2017-06-04

    Sakshar Mahila Smooh (SMS) program was launched in rural areas of Haryana in India during 2008. A total of 6788 SMSs, each having 5-10 literate women, were equipped to enhance health communication. We carried out process evaluation of this program as an external agency. After a review of program documents, a random sample survey of Auxiliary Nurse Midwives (ANMs), SMS members, and village women was conducted. Out of four divisions of the state, one was randomly chosen, which had five districts. From 330 randomly chosen villages, 283 ANMs, 1164 SMS members, and 1123 village women were interviewed using a semi- structured interview schedule. Program inputs, processes, and outputs were compared in the five districts. Chi square was used for significance test. In the sampled division, out of 2009 villages, 1732 (86%) had functional SMS. In three years, SMS conducted 15036 group meetings, 2795 rallies, 2048 wall writings, and 803 competitions, and 44.5% of allocated budget was utilized. Most ANMs opined that SMSs are better health communicators. SMS members were aware about their roles and responsibilities. Majority of village women reported that SMS carry out useful health education activities. The characteristics of SMS members were similar but program performance was better in districts where health managers were proactive in program planning and monitoring. SMS Program has communicated health messages to majority of rural population, however, better planning & monitoring can improve program performance. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. 77 FR 59931 - Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program...

    Science.gov (United States)

    2012-10-01

    ... HUMAN SERVICES Health Resources and Services Administration Single Source Program Expansion Supplement... baccalaureate nursing education program in the Pacific. Its focus is on health careers training and development..., program resource purchases, and faculty development. FOR FURTHER INFORMATION CONTACT: Meseret Bezuneh...

  20. SHPPS 2006: School Health Policies and Programs Study--Nutrition

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the following areas, as they relate to nutrition: (1) Health Education; (2) Health Services and Mental Health and…

  1. Pilot evaluation of the text4baby mobile health program

    Directory of Open Access Journals (Sweden)

    Evans William Douglas

    2012-11-01

    Full Text Available Abstract Background Mobile phone technologies for health promotion and disease prevention have evolved rapidly, but few studies have tested the efficacy of mobile health in full-fledged programs. Text4baby is an example of mobile health based on behavioral theory, and it delivers text messages to traditionally underserved pregnant women and new mothers to change their health, health care beliefs, practices, and behaviors in order to improve clinical outcomes. The purpose of this pilot evaluation study is to assess the efficacy of this text messaging campaign. Methods We conducted a randomized pilot evaluation study. All participants were pregnant women first presenting for care at the Fairfax County, Virginia Health Department. We randomized participants to enroll in text4baby and receive usual health care (intervention, or continue simply to receive usual care (control. We then conducted a 24-item survey by telephone of attitudes and behaviors related to text4baby. We surveyed participants at baseline, before text4baby was delivered to the intervention group, and at follow-up at approximately 28 weeks of baby’s gestational age. Results We completed 123 baseline interviews in English and in Spanish. Overall, the sample was predominantly of Hispanic origin (79.7% with an average age of 27.6 years. We completed 90 follow-up interviews, and achieved a 73% retention rate. We used a logistic generalized estimating equation model to evaluate intervention effects on measured outcomes. We found a significant effect of text4baby intervention exposure on increased agreement with the attitude statement “I am prepared to be a new mother” (OR = 2.73, CI = 1.04, 7.18, p = 0.042 between baseline and follow-up. For those who had attained a high school education or greater, we observed a significantly higher overall agreement to attitudes against alcohol consumption during pregnancy (OR = 2.80, CI = 1.13, 6.90, p = 0.026. We also observed a

  2. Physical fitness and health education program at NASA Headquarters

    Science.gov (United States)

    Angotti, Cathy

    1993-01-01

    The topics discussed include the following: policy procedures to enter the NASA Headquarters Physical Fitness and Health Program; eligibility; TDY eligibility; health promotions offered; and general facility management.

  3. Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial.

    Science.gov (United States)

    West, Delia Smith; Bursac, Zoran; Cornell, Carol E; Felix, Holly C; Fausett, Jennifer K; Krukowski, Rebecca A; Lensing, Shelly; Love, Sharhonda J; Prewitt, T Elaine; Beck, Cornelia

    2011-10-01

    Older adults have high obesity rates and respond well to evidence-based weight-loss programs, such as the Diabetes Prevention Program (DPP) Lifestyle intervention. The goal of this study was to determine whether a translation of the DPP Lifestyle program delivered by lay health educators and conducted in senior centers is effective in promoting weight loss among older adults. An RCT with older adults nested within senior centers. Senior centers identified lay health educators to receive training and deliver the intervention program at the senior center. Senior centers were randomized to DPP Lifestyle program or an attention control intervention (cognitive training). Senior centers (N=15) located throughout Arkansas. Participants (N=228) were obese (BMI=34.5±4.9) older (aged 71.2±6.6 years) adults able to engage in moderate exercise. Follow-up data were collected at 4 months on 93% of the original cohort between February 2009 and July 2010. A 12-session translation of the Diabetes Prevention Program Lifestyle behavioral weight-control program delivered in group sessions by trained lay health educators. Body weight was assessed by digital scale. Percentage weight loss from baseline and proportion achieving ≥5% and ≥7% weight loss were examined. Analyses were completed in March 2011. Participants attending senior centers randomized to Lifestyle lost a significantly greater percentage of baseline weight (3.8%, 95% CI=2.9%, 4.6%) than those in the control senior centers (0.2%, 95% CI= -0.6%, -0.9%) after adjusting for baseline BMI and gender (psenior centers offering the Lifestyle program, 38% lost ≥5% of baseline weight compared with 5% in the control arm (pLifestyle senior centers lost ≥7% than did control participants (3%, p=0.001). A behavioral lifestyle weight-loss intervention delivered by a lay health educator offers a promising vehicle for translation of evidence-based obesity treatment programs in underserved areas. This study is registered at

  4. Functional and psychosocial effects of health qigong in patients with COPD: a randomized controlled trial.

    Science.gov (United States)

    Ng, Bobby H P; Tsang, Hector W H; Jones, Alice Y M; So, C T; Mok, Thomas Y W

    2011-03-01

    The initial gain from a Pulmonary Rehabilitation Program (PRP) among patients with chronic obstructive pulmonary disease (COPD) begins to fade away 6 months after the completion of a rehabilitation program. One possible reason may be due to the poor compliance of the patients to the existing forms of home exercise program (e.g., walking, weight training activities, etc.). This study tested the efficacy of health qigong (HQG), a traditional Chinese exercise, as an adjunct home exercise program in optimizing the gains obtained from PRP until 6 months after discharge. This was a randomized controlled trial (RCT) on a mind-body exercise intervention. Eighty (80) patients with COPD receiving conventional PRP pulmonary rehabilitation program were randomized to the HQG intervention group (n = 40) and control group (n = 40). Assessments were undertaken by blinded assessors at baseline, discharge from training, and follow-up (FU) at 3 and 6 months. Primary outcomes involved functional capacity scales and secondary outcomes involved quality-of-life scales. Intention-to-treat analysis identified trends of improvement in all outcome measures in the HQG group, whereas lesser improvement and trends of deteriorations were identified in the control group. Ancillary analysis using a per-protocol method, however, identified significantly better improvements in functional capacity measures among the HQG at the 6-month FU. This RCT provided some evidence to support the positive effect of HQG as an adjunct home exercise for rehabilitation among people with COPD and to support further related research.

  5. Study Protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities

    Directory of Open Access Journals (Sweden)

    Rousseau Sally

    2010-10-01

    Full Text Available Abstract Background Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment. Methods/Design The Rochester Patient Navigation Research Program (PNRP is a National Cancer Institute-sponsored, patient-level randomized trial (RCT of patient navigation and activation, targeting newly-diagnosed breast and colorectal cancer patients in Rochester, NY. The goal of the program is to decrease cancer health disparities by addressing barriers to receipt of cancer care and promoting patient self-efficacy. The intervention uses trained, paraprofessional patient navigators recruited from the target community, and a detailed training and supervisory program. Recruited patients are randomly assigned to receive either usual care (except for baseline and follow-up questionnaires and interviews or intervention. The intervention patients receive tailored assistance from their patient navigators, including phone calls, in-person meetings, and behind-the-scenes coordination of care. A total of 344 patients have been recruited. Outcomes measured at three month intervals include timeliness of care, patient adherence, patient satisfaction, quality of life, self-efficacy, health literacy, and cancer knowledge. Discussion This unique intervention combining patient navigation and patient activation is designed to address the multifactorial problem of cancer health disparities. If successful, this study will affect the design and implementation of patient navigation programs. Trials Registration clinicaltrials.gov identifier NCT

  6. Biomedical image analysis using Markov random fields & efficient linear programing.

    Science.gov (United States)

    Komodakis, Nikos; Besbes, Ahmed; Glocker, Ben; Paragios, Nikos

    2009-01-01

    Computer-aided diagnosis through biomedical image analysis is increasingly considered in health sciences. This is due to the progress made on the acquisition side, as well as on the processing one. In vivo visualization of human tissues where one can determine both anatomical and functional information is now possible. The use of these images with efficient intelligent mathematical and processing tools allows the interpretation of the tissues state and facilitates the task of the physicians. Segmentation and registration are the two most fundamental tools in bioimaging. The first aims to provide automatic tools for organ delineation from images, while the second focuses on establishing correspondences between observations inter and intra subject and modalities. In this paper, we present some recent results towards a common formulation addressing these problems, called the Markov Random Fields. Such an approach is modular with respect to the application context, can be easily extended to deal with various modalities, provides guarantees on the optimality properties of the obtained solution and is computationally efficient.

  7. Health education for microcredit clients in Peru: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fernald Lia CH

    2011-01-01

    Full Text Available Abstract Background Poverty, lack of female empowerment, and lack of education are major risk factors for childhood illness worldwide. Microcredit programs, by offering small loans to poor individuals, attempt to address the first two of these risk factors, poverty and gender disparity. They provide clients, usually women, with a means to invest in their businesses and support their families. This study investigates the health effects of also addressing the remaining risk factor, lack of knowledge about important health issues, through randomization of members of a microcredit organization to receive a health education module based on the World Health Organization's Integrated Management of Childhood Illness (IMCI community intervention. Methods Baseline data were collected in February 2007 from clients of a microcredit organization in Pucallpa, Peru (n = 1,855 and their children (n = 598. Loan groups, consisting of 15 to 20 clients, were then randomly assigned to receive a health education intervention involving eight monthly 30-minute sessions given by the organization's loan officers at monthly loan group meetings. In February 2008, follow-up data were collected, and included assessments of sociodemographic information, knowledge of child health issues, and child health status (including child height, weight, and blood hemoglobin levels. To explore the effects of treatment (i.e., participation in the health education sessions on the key outcome variables, multivariate regressions were implemented using ordinary least squares. Results Individuals in the IMCI treatment arm demonstrated more knowledge about a variety of issues related to child health, but there were no changes in anthropometric measures or reported child health status. Conclusions Microcredit clients randomized to an IMCI educational intervention showed greater knowledge about child health, but no differences in child health outcomes compared to controls. These results imply

  8. How federalism shapes public health financing, policy, and program options.

    Science.gov (United States)

    Ogden, Lydia L

    2012-01-01

    In the United States, fiscal and functional federalism strongly shape public health policy and programs. Federalism has implications for public health practice: it molds financing and disbursement options, including funding formulas, which affect allocations and program goals, and shapes how funding decisions are operationalized in a political context. This article explores how American federalism, both fiscal and functional, structures public health funding, policy, and program options, investigating the effects of intergovernmental transfers on public health finance and programs.

  9. Health effects of unemployment benefit program generosity.

    Science.gov (United States)

    Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

    2015-02-01

    We assessed the impact of unemployment benefit programs on the health of the unemployed. We linked US state law data on maximum allowable unemployment benefit levels between 1985 and 2008 to individual self-rated health for heads of households in the Panel Study of Income Dynamics and implemented state and year fixed-effect models. Unemployment was associated with increased risk of reporting poor health among men in both linear probability (b=0.0794; 95% confidence interval [CI]=0.0623, 0.0965) and logistic models (odds ratio=2.777; 95% CI=2.294, 3.362), but this effect is lower when the generosity of state unemployment benefits is high (b for interaction between unemployment and benefits=-0.124; 95% CI=-0.197, -0.0523). A 63% increase in benefits completely offsets the impact of unemployment on self-reported health. Results suggest that unemployment benefits may significantly alleviate the adverse health effects of unemployment among men.

  10. 75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Science.gov (United States)

    2010-07-28

    .... Medicare and Medicaid Programs; Electronic Health Record Incentive Program; Final Rule #0;#0;Federal... RIN 0938-AP78 Medicare and Medicaid Programs; Electronic Health Record Incentive Program AGENCY... meaningful use of certified electronic health record (EHR) technology. This final rule specifies--the initial...

  11. 75 FR 63480 - Medicaid Program: Implementation of Section 614 of the Children's Health Insurance Program...

    Science.gov (United States)

    2010-10-15

    ... HUMAN SERVICES Medicaid Program: Implementation of Section 614 of the Children's Health Insurance... Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), Public Law 111-3. Section 614... Security Act and for child health assistance expenditures under the Children's Health Insurance Program...

  12. Child Health, Developmental Plasticity, and Epigenetic Programming

    Science.gov (United States)

    Feil, R.; Constancia, M.; Fraga, M.; Junien, C.; Carel, J.-C.; Boileau, P.; Le Bouc, Y.; Deal, C. L.; Lillycrop, K.; Scharfmann, R.; Sheppard, A.; Skinner, M.; Szyf, M.; Waterland, R. A.; Waxman, D. J.; Whitelaw, E.; Ong, K.; Albertsson-Wikland, K.

    2011-01-01

    Plasticity in developmental programming has evolved in order to provide the best chances of survival and reproductive success to the organism under changing environments. Environmental conditions that are experienced in early life can profoundly influence human biology and long-term health. Developmental origins of health and disease and life-history transitions are purported to use placental, nutritional, and endocrine cues for setting long-term biological, mental, and behavioral strategies in response to local ecological and/or social conditions. The window of developmental plasticity extends from preconception to early childhood and involves epigenetic responses to environmental changes, which exert their effects during life-history phase transitions. These epigenetic responses influence development, cell- and tissue-specific gene expression, and sexual dimorphism, and, in exceptional cases, could be transmitted transgenerationally. Translational epigenetic research in child health is a reiterative process that ranges from research in the basic sciences, preclinical research, and pediatric clinical research. Identifying the epigenetic consequences of fetal programming creates potential applications in clinical practice: the development of epigenetic biomarkers for early diagnosis of disease, the ability to identify susceptible individuals at risk for adult diseases, and the development of novel preventive and curative measures that are based on diet and/or novel epigenetic drugs. PMID:20971919

  13. SHPPS 2006: School Health Policies and Programs Study--Overview

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. SHPPS 2006 was designed to answer the following questions: (1) What are the characteristics of each school health program component at the state,…

  14. A worksite prevention program for construction workers: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Proper Karin I

    2010-06-01

    Full Text Available Abstract Background A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program compared with usual care for construction workers. Methods The study is designed as a randomized controlled trial with a follow-up of one year. Employees eligible for this study are construction workers performing actual construction work. The worksite intervention will be compared with usual care. This intervention was developed by using the Intervention Mapping approach and consists of the following components: (1 two individual training sessions of a physical therapist to lower the physical workload, (2 a Rest-Break tool to improve the balance between work and recovery, and (3 two empowerment training sessions to increase the influence of the construction workers at the worksite. Outcome measures are assessed at baseline, 3, 6, and 12 months. The primary outcome measures of this study are work ability and health-related quality of life. Secondary outcome measures include need for recovery, musculoskeletal complaints, work engagement and self efficacy. Cost-effectiveness will be evaluated from the company perspective. Moreover, a process evaluation will be conducted. Discussion The feasibility of the intervention and the study has been enhanced by creating an intervention program that explicitly appeals to construction workers and will not interfere too much with the ongoing construction. The feasibility and effectiveness of this worksite prevention program will be investigated by means of an effect- and a process evaluation. If proven effective, this worksite prevention program can be implemented on a larger scale within the construction industry. Trial Registration NTR1278

  15. Variance approach for multi-objective linear programming with fuzzy random of objective function coefficients

    Science.gov (United States)

    Indarsih, Indrati, Ch. Rini

    2016-02-01

    In this paper, we define variance of the fuzzy random variables through alpha level. We have a theorem that can be used to know that the variance of fuzzy random variables is a fuzzy number. We have a multi-objective linear programming (MOLP) with fuzzy random of objective function coefficients. We will solve the problem by variance approach. The approach transform the MOLP with fuzzy random of objective function coefficients into MOLP with fuzzy of objective function coefficients. By weighted methods, we have linear programming with fuzzy coefficients and we solve by simplex method for fuzzy linear programming.

  16. Ethical issues posed by cluster randomized trials in health research

    Directory of Open Access Journals (Sweden)

    Donner Allan

    2011-04-01

    Full Text Available Abstract The cluster randomized trial (CRT is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. However, cluster trials raise difficult ethical issues that challenge researchers, research ethics committees, regulators, and sponsors as they seek to fulfill responsibly their respective roles. Our project will provide a systematic analysis of the ethics of cluster trials. Here we have outlined a series of six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation: 1. Who is a research subject? 2. From whom, how, and when must informed consent be obtained? 3. Does clinical equipoise apply to CRTs? 4. How do we determine if the benefits outweigh the risks of CRTs? 5. How ought vulnerable groups be protected in CRTs? 6. Who are gatekeepers and what are their responsibilities? Subsequent papers in this series will address each of these areas, clarifying the ethical issues at stake and, where possible, arguing for a preferred solution. Our hope is that these papers will serve as the basis for the creation of international ethical guidelines for the design and conduct of cluster randomized trials.

  17. Worksite health and wellness programs in India.

    Science.gov (United States)

    Babu, Abraham Samuel; Madan, Kushal; Veluswamy, Sundar Kumar; Mehra, Rahul; Maiya, Arun G

    2014-01-01

    Worksite health and wellness (WH&W) are gaining popularity in targeting cardiovascular (CV) risk factors among various industries. India is a large country with a larger workforce in the unorganized sector than the organized sector. This imbalance creates numerous challenges and barriers to implementation of WH&W programs in India. Large scale surveys have identified various CV risk factors across various industries. However, there is scarcity of published studies focusing on the effects of WH&W programs in India. This paper will highlight: 1) the current trend of CV risk factors across the industrial community, 2) the existing models of delivery for WH&W in India and their barriers, and 3) a concise evidence based review of various WH&W interventions in India.

  18. School Health Programs in Australia - A Special Insert.

    Science.gov (United States)

    Nader, Philip R.; Rissel, Chris; Rowling, Louise; Marshall, Bernard J.; Sheehan, Margaret M.; Northfield, Jeff R.; Maher, Shelley; Carlisle, Rachel; St. Leger, Lawrence H.; Stewart, Donald E.; Parker, Elizabeth; Gillespie, Amaya; Stokes, Helen; Mukherjee, Dev; Nutbeam, Don; Mitchell, Anne; Ollis, Debbie; Watson, Jan

    2000-01-01

    Eight papers on Australia's school health programs discuss: creating health promoting schools in the United States; intersectoral collaboration for developing a national framework for health promoting schools; school-based health promotion nationwide; auditing health promoting schools policy documentation; the nature of health service/school…

  19. Graduate programs in health administration: faculty academic reputation and faculty research reputation by program location and program reputation.

    Science.gov (United States)

    Nowicki, M

    1995-01-01

    This study used program location and program reputation to describe two important faculty characteristics: academic reputation and research reputation. The study involved 44 graduate programs in health administration representing four program locations: schools of public health, business, medicine/allied health, and graduate/independent. Fourteen programs were identified as ranked programs and the remaining 30 programs were identified as unranked programs. While the study identifies many differences, few are significant, thus adding credence to the argument for diversity in program location and diminishing credence in the argument for program reputation.

  20. 76 FR 58006 - Consumer Health IT Pledge Program

    Science.gov (United States)

    2011-09-19

    ... HUMAN SERVICES Consumer Health IT Pledge Program AGENCY: Office of the National Coordinator for Health Information Technology, HHS. ACTION: Notice of availability for Consumer Health IT Pledge Program. SUMMARY... another for those who do not manage or maintain consumer health data, but have the ability to...

  1. ASTDD Synopses of State Oral Health Programs - Selected indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011-2015. The ASTDD Synopses of State Oral Health Programs contain information useful in tracking states’ efforts to improve oral health and contributions to...

  2. ASTDD Synopses of State Oral Health Programs - Selected indicators

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2011-2016. The ASTDD Synopses of State Oral Health Programs contain information useful in tracking states’ efforts to improve oral health and contributions to...

  3. Effect of a program of multifactorial fall prevention on health-related quality of life, functional ability, fear of falling and psychological well-being. A randomized controlled trial

    DEFF Research Database (Denmark)

    Vind, Ane Bonnerup; Andersen, Hanne Elkjaer; Pedersen, Kirsten Damgaard

    2010-01-01

    Falls among older people are associated with injury, functional decline, fear of falling, and depression. This study aims to evaluate the effect of multifactorial fall prevention on function, fear of falling, health-related quality of life and psychological well-being.......Falls among older people are associated with injury, functional decline, fear of falling, and depression. This study aims to evaluate the effect of multifactorial fall prevention on function, fear of falling, health-related quality of life and psychological well-being....

  4. Epigenomic programing: a future way to health?

    Science.gov (United States)

    Shenderov, Boris A; Midtvedt, Tore

    2014-01-01

    It is now generally accepted that the 'central genome dogma' (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions) should be replaced by the 'fluid genome dogma', that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing - and reprograming - throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases - often called 'civilization diseases' - are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life - from conception into early infancy - is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a 'Human Gut Microbiota and Epigenomic Platform' in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  5. Epigenomic programing: a future way to health?

    Directory of Open Access Journals (Sweden)

    Boris A. Shenderov

    2014-05-01

    Full Text Available It is now generally accepted that the ‘central genome dogma’ (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions should be replaced by the ‘fluid genome dogma’, that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing – and reprograming – throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabolism and microbiota as well as external factors such as diet, pharmaceuticals, environmental compounds, and so on. It is a growing body of results indicating that many chronic metabolic and degenerative disorders and diseases – often called ‘civilization diseases’ – are initiated and/or influenced upon by non-optimal epigenomic programing, often taking place early in life. In this context, the first 1,000 days of life – from conception into early infancy – is often called the most important period of life. The following sections present some major mechanisms for epigenomic programing as well as some factors assumed to be of importance. The need for more information about own genome and metagenome, as well as a substantial lack of adequate information regarding dietary and environmental databases are also commented upon. However, the mere fact that we can influence epigenomic health programing opens up the way for prophylactic and therapeutic interventions. The authors underline the importance of creating a ‘Human Gut Microbiota and Epigenomic Platform’ in order to facilitate interdisciplinary collaborations among scientists and clinicians engaged in host microbial ecology, nutrition, metagenomics, epigenomics and metabolomics as well as in disease epidemiology, prevention and treatment.

  6. 78 FR 4593 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-22

    ... 42 CFR Parts 430, 431, 433, et al. 45 CFR Part 155 Medicaid, Children's Health Insurance Programs... Health Insurance Programs, and Exchanges: Essential Health Benefits in Alternative Benefit Plans... Affordable Care Act), and the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This...

  7. Programs to improve adolescent sexual and reproductive health in the US: a review of the evidence

    Directory of Open Access Journals (Sweden)

    Manlove J

    2015-04-01

    Full Text Available Jennifer Manlove, Heather Fish, Kristin Anderson Moore Child Trends, Bethesda, MD, USA Background: US adolescents have high rates of teen pregnancy, childbearing, and sexually transmitted infections (STIs, highlighting the need to identify and implement effective programs that will help improve teen sexual and reproductive health. Materials and methods: This review identified 103 random-assignment evaluations of 85 programs that incorporated intent-to-treat analyses and assessed impacts on pregnancy, childbearing, STIs, and their key determinants – sexual activity, number of sexual partners, condom use, and other contraceptive use – among teens. This review describes the evidence base for five broad program approaches, including abstinence education, comprehensive sex education, clinic-based programs, youth development programs, and parent–youth relationship programs. We also describe programs with impacts on key outcomes, including pregnancy/childbearing, STIs, and those that found impacts on both sexual activity and contraceptive use. Results: Our review identified 52 effective programs: 38 with consistent impacts on reproductive health outcomes, and 14 with mixed findings (across subpopulations, follow-ups, or multiple measures of a single outcome. We found that a variety of program approaches produced impacts on sexual and reproductive health outcomes. Parent–youth relationship programs and clinic-based program evaluations more frequently showed impacts than other program approaches, although we also identified a number of abstinence-education, comprehensive sex education, and youth-development programs with impacts on sexual and reproductive health outcomes. Overall, we identified nine program evaluations with impacts on teen pregnancies or births, five with impacts on reducing STIs, and 15 with impacts on both delaying/reducing sexual activity and increasing contraceptive use (including condom use. Conclusion: Future efforts should

  8. A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Pellegrini Christine A

    2012-11-01

    Full Text Available Abstract Background Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Methods/design Ninety-six obese adults (BMI 30–39.9 kg/m2 will be randomized to one of three treatment conditions: (1 standard behavioral weight loss (STND, (2 technology-supported behavioral weight loss (TECH; or (3 self-guided behavioral weight loss (SELF. All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD’s and will not receive coaching calls. During months 1–6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer. STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. Trial registration NCT01051713

  9. Social security health insurance for the informal sector in Nicaragua: a randomized evaluation.

    Science.gov (United States)

    Thornton, Rebecca L; Hatt, Laurel E; Field, Erica M; Islam, Mursaleena; Diaz, Freddy Solís; González, Martha Azucena

    2010-09-01

    This article presents the results from an experimental evaluation of a voluntary health insurance program for informal sector workers in Nicaragua. Costs of the premiums as well as enrollment location were randomly allocated. Overall, take-up of the program was low, with only 20% enrollment. Program costs and streamlined bureaucratic procedures were important determinants of enrollment. Participation of local microfinance institutions had a slight negative effect on enrollment. One year later, those who received insurance substituted toward services at covered facilities and total out-of-pocket expenditures fell. However, total expenditures fell by less than the insurance premiums. We find no evidence of an increase in health-care utilization among the newly insured. We also find very low retention rates after the expiration of the subsidy, with less than 10% of enrollees still enrolled after one year. To shed light on the findings from the experimental results, we present qualitative evidence of institutional and contextual factors that limited the success of this program.

  10. A randomized controlled trial evaluating the active communication education program for older people with hearing impairment.

    Science.gov (United States)

    Hickson, Louise; Worrall, Linda; Scarinci, Nerina

    2007-04-01

    To evaluate the effectiveness of the Active Communication Education (ACE) program for older people with hearing impairment and to investigate factors that influence response to the program. The ACE is a group program that runs for 2 hr per week for 5 wk. In this double-blinded, randomized, controlled trial, 178 older people with, on average, mild to moderate hearing impairment were randomly allocated to one of two groups. Approximately half had been fitted with hearing aid/s in the past. One group (N = 78) undertook a placebo social program for the first 5 wk, followed by the ACE program. They were assessed before the social program, immediately after it, and then again immediately post-ACE. The other group (N = 100) undertook the ACE program only and were assessed before and after ACE. In addition, 167 participants were reassessed 6 mo after completing ACE. Assessments were all self-report and included two sets of measures: 1) those administered both before and after the program-the Hearing Handicap Questionnaire, the Quantified Denver Scale of Communicative Function, the Self-Assessment of Communication, the Ryff Psychological Well-Being Scale, the Short-Form 36 health-related quality of life measure; and 2) those administered postprogram only-the Client Oriented Scale of Improvement, the International Outcome Inventory-Alternative Interventions, and a qualitative questionnaire. All assessments were conducted by a researcher blinded to participants' group membership. The relationships between participant response to the ACE program and a number of client-related factors were also investigated. These factors were the participants' age, gender, hearing loss, hearing aid use, attitudes to hearing impairment (as measured using the Hearing Attitudes to Rehabilitation Questionnaire) and the involvement of significant others. For those participants who completed the social program initially, significant improvements were found on the Quantified Denver Scale of

  11. 77 FR 53967 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2

    Science.gov (United States)

    2012-09-04

    ... & Medicaid Services 42 CFR Parts 412, 413, and 495 Medicare and Medicaid Programs; Electronic Health Record... Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent... Programs; Electronic Health Record Incentive Program--Stage 2 AGENCY: Centers for Medicare & Medicaid...

  12. Incentive Pay Programs Do Not Affect Teacher Motivation or Reported Practices: Results from Three Randomized Studies

    Science.gov (United States)

    Yuan, Kun; Le, Vi-Nhuan; McCaffrey, Daniel F.; Marsh, Julie A.; Hamilton, Laura S.; Stecher, Brian M.; Springer, Matthew G.

    2013-01-01

    This study drew on teacher survey responses from randomized experiments exploring three different pay-for-performance programs to examine the extent to which these programs motivated teachers to improve student achievement and the impact of such programs on teachers' instruction, number of hours worked, job stress, and collegiality. Results showed…

  13. National Implementation of an Evidence-Based HIV Prevention and Reproductive Health Program for Bahamian Youth

    Science.gov (United States)

    Knowles, Valerie; Kaljee, Linda; Deveaux, Lynette; Lunn, Sonja; Rolle, Glenda; Stanton, Bonita

    2012-01-01

    A wide range of behavioral prevention interventions have been demonstrated through longitudinal, randomized controlled trials to reduce sexual risk behaviors. Many of these interventions have been made available at little cost for implementation on a public health scale. However, efforts to utilize such programs typically have been met with a…

  14. Best practices in evaluating worksite health promotion programs.

    Science.gov (United States)

    Grossmeier, Jessica; Terry, Paul E; Cipriotti, Aldo; Burtaine, Jeffrey E

    2010-01-01

    Program evaluation is generally recognized as a "best practice" activity for worksite health promotion programs. The importance of "best practice" worksite health promotion programming is increasing with the stakes anticipated by health care reform. Volvo's health promotion activities are used as an example of "best practice" programming with a particular focus on creating a dashboard of evaluation metrics that can meet the accountability needs of senior management. The role of a comprehensive evaluation framework using nine components is explored along with reasonable expectations for program outcomes. Finally, stakeholder utility from the evaluation approach is explored.

  15. RANDOM: A Computer Program for Evaluating Pseudo-Uniform RANDOM Number Generators.

    Science.gov (United States)

    1982-08-01

    correlation employed in RANDOM is taken from Wald and Wolfowitz (1943) and is performed using both the circular and noncircular definitions. The theory behind...Addison-Wesley, 1962). Wald , A. and J. Wolfowitz , "An Exact Test for Randomness in the Non-Parametric Case Based on Serial Correlation," Annals of...measures the interdependence between these two variables. If p = q, the covariance between R and Rq is equivalent to the variance of Rp. Wolfowitz (1944

  16. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Burton E

    2013-12-01

    Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

  17. Understanding Evaluation Training in Schools and Programs of Public Health

    Science.gov (United States)

    Fierro, Leslie A.; Christie, Christina A.

    2011-01-01

    This study provides an understanding of how the coursework required for attaining a Masters of Public Health (MPH) degree in epidemiology or health education from accredited schools or programs of public health prepares students to evaluate programs or interventions. Study data were generated using a content analysis of required coursework…

  18. Wellness Programs: Preventive Medicine to Reduce Health Care Costs.

    Science.gov (United States)

    Martini, Gilbert R., Jr.

    1991-01-01

    A wellness program is a formalized approach to preventive health care that can positively affect employee lifestyle and reduce future health-care costs. Describes programs for health education, smoking cessation, early detection, employee assistance, and fitness, citing industry success figures. (eight references) (MLF)

  19. 42 CFR 441.106 - Comprehensive mental health program.

    Science.gov (United States)

    2010-10-01

    ... SERVICES Medicaid for Individuals Age 65 or Over in Institutions for Mental Diseases § 441.106 Comprehensive mental health program. (a) If the plan includes services in public institutions for mental... 42 Public Health 4 2010-10-01 2010-10-01 false Comprehensive mental health program....

  20. [Effects of an exercise and relaxation aquatic program in patients with spondyloarthritis: A randomized trial].

    Science.gov (United States)

    Fernández García, Rubén; Sánchez Sánchez, Laura de Carmen; López Rodríguez, María Del Mar; Sánchez Granados, Gema

    2015-11-06

    Spondyloarthritis is a general term referring to a group of chronic rheumatic illnesses that share clinical, genetic, radiological and epidemiological features. The clinical presentation of spondyloarthritis is characterized by the compromise of both the axial and peripheral articular skeleton. We aimed to evaluate the efficacy of an aquatic exercise plus relaxation program in patients with spondyloarthritis. This was a randomized single blind study including 30 patients with spondylitis who were randomly assigned to an experimental or control group. For 2 months, the experimental group underwent an aquatic fitness plus relaxation program (3 sessions per week). Evaluations were also performed in the control group the same days as the experimental group but they did not participate in any supervised exercise program. The following data were obtained at baseline and immediately after application of the last session: Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, Health Questionnaire SF-12 and Sigma PC3(®) (Sigma-Elektro GmbH, Neustadt, Germany) Heart Rate Monitor. The Mann-Whitney test showed statistically significant differences in the quality of life (physical function [P=.05]), Bath Ankylosing Spondylitis Functional Index (P=.015), Bath Ankylosing Spondylitis Disease Activity Index (fatigue [P=.032], neck pain, back and hips [P=.045], pain or swelling in other joints [P=.032] and in waking morning stiffness [P=.019]). The results of the present study suggest that therapy with physical exercise plus relaxation provides benefits to spondyloarthritis patients and these are advised as a part of their usual treatment. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  1. A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff.

    Science.gov (United States)

    Jeffcoat, Tami; Hayes, Steven C

    2012-09-01

    The mental health challenges of some vocations present a challenge for current intervention models. Bibliotherapy focused on transdiagnostic processes that might both prevent and alleviate a range of mental health distress could be an effective and practical approach. K-12 school personnel (N = 236; 91% female; 30-60 years old) responding to a wellness-oriented program announcement were randomized to receive an Acceptance and Commitment Therapy (ACT) self-help volume or to a waitlist. Three-fourths were above clinical cutoffs in general mental health, depression, anxiety, or stress. Participants read the book for two months, completed exercises and quizzes, and after post assessment were followed for 10 weeks; waitlist participants were then also given the book with two months to complete it. Overall, participants showed significant improvement in psychological health. Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression, anxiety and stress. Follow up general mental health, depression, and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility.

  2. The value of including spirometry in health checks - a randomized controlled study in primary health care

    DEFF Research Database (Denmark)

    Ørts, Lene Maria; Ottesen, Anders Løkke; Bjerregaard, Anne-Louise

    studies in the Ph.D. project will evaluate whether early spirometry measurements can be used to predict future lung disease and describe the follow up of patients with abnormal spirometry measurements at the general practitioner. Disclosure of interest: None to declare. Key words: early spirometry......Background Lung diseases are among the most frequent and most serious ailments in Denmark. Preventive health checks including spirometry can be used to detect lung diseases earlier. Over time the attendance at preventive health checks has decreased and at present the response rate is approximately...... 50%. Little is known about initiatives that can influence the attendance rate. Objectives To examine whether focused information on spirometry in the invitation material will influence the attendance in preventive health checks. Materiel/Methods Design: A randomized controlled study on information...

  3. Impact of an integrated intervention program on atorvastatin adherence: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Goswami NJ

    2013-07-01

    Full Text Available Nilesh J Goswami,1 Mitch DeKoven,2 Andreas Kuznik,3 Jack Mardekian,3 Michelle R Krukas,2 Larry Z Liu,3,4 Patrick Bailey,1 Cynthia Deitrick,5 John Vincent3 1Prairie Heart Cardiovascular Consultants, Springfield, IL, USA; 2Health Economics and Outcomes Research, IMS Health, Alexandria, VA, USA; 3Pfizer Inc, New York, NY, USA; 4Weill Cornell Medical College, Cornell University, New York, NY, USA; 5Prairie Heart Education and Research Cooperative, Springfield, IL, USA Background: This trial evaluated the effectiveness of an integrated intervention program that included a 3-to-5-minute nurse counseling session, copay relief cards, and a monthly newsletter on adherence to atorvastatin treatment. Methods and results: A prospective, integrated (composed of nurse counseling, adherence tip sheet, copay relief card, opportunity to enroll in 12-week cholesterol management program randomized interventional study was designed involving patients >21 years of age who were prescribed atorvastatin at a large single-specialty cardiovascular physician practice in Illinois from March 2010 to May 2011. Data from the practice's electronic medical record were matched/merged to IMS Health's longitudinal data. A total of 500 patients were enrolled (125 in the control arm; 375 in the intervention arm. After data linkage, 53 control patients and 155 intervention patients were included in the analysis. Results: Mean age was 67.8 years (control and 69.5 years (intervention; 67.9% and 58.7%, respectively, were male. The mean 6-month adherence rate was 0.82 in both arms. The mean proportion of days covered for both the new-user control and intervention groups was the same, averaging 0.70 day (standard deviation [SD], 0.27 day; for continuing users, the proportion of days covered for the control group was 0.83 (SD, 0.24 and for the intervention group was 0.84 (SD, 0.22. For continuing users, the control group had mean persistent days of 151.6 (SD, 50.2 compared with 150.9 days

  4. Implementation of "Heart Smart:" A Cardiovascular School Health Promotion Program.

    Science.gov (United States)

    Downey, Ann M.; And Others

    1987-01-01

    "Heart Smart," a research-based health promotion program for elementary schools, was tested in four elementary schools. The program's objectives, strategies, curriculum, and other components are described. (Author/MT)

  5. Abstract: Rwanda Human Resources for Health Program: Genesis ...

    African Journals Online (AJOL)

    Abstract: Rwanda Human Resources for Health Program: Genesis and Evolution ... a program to dramatically improve nursing and midwifery education and practice. ... academic institutions requires flexibility, respect, and thoughtful planning.

  6. Outcomes from a School-Randomized Controlled Trial of Steps to Respect: A Bullying Prevention Program

    Science.gov (United States)

    Brown, Eric C.; Low, Sabina; Smith, Brian H.; Haggerty, Kevin P.

    2011-01-01

    This study reports the outcomes of a randomized controlled trial of Steps to Respect: A Bullying Prevention Program conducted in 33 California elementary schools. Schools were matched on school demographic characteristics and assigned randomly to intervention or waitlisted control conditions. Outcome measures were obtained from (a) all school…

  7. Association of Schools and Programs of Public Health

    Science.gov (United States)

    ... Before You Apply Financing Your Degree Fellowships and Internships Certified in Public Health ASPPH Public Health Graduate ... Our resources help maintain the highest standards for teaching and training. Educate Our member schools and programs ...

  8. Effect of NICU Department Orientation Program on Mother’s Anxiety: a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Leila Valizadeh

    2016-09-01

    Full Text Available Introduction: Neonatal intensive care unit induces the high level of anxiety for mothers. The aim of this study was to evaluate the effectiveness of NICU orientation program on the anxiety of mothers who had preterm newborns hospitalized in NICU. Methods: This study was a randomized clinical trial (three parallel groups. Participants included 99 mothers with preterm newborns hospitalized in NICU of Al- Zahra hospital, affiliated to Tabriz University of Medical Sciences in 2015. Mothers were randomly assigned to one of three groups (film, booklet, and control. Mothers completed the State- Trait Anxiety Inventory before entering to the NICU, and then mothers in the experiment groups became familiar with the NICU environment through watching a film or reading booklet. After the first NICU visit, all mothers completed the STAI and Cattell's Anxiety Questionnaires. Data were analyzed using SPSS ver. 13 software. Results: There was no significant difference between three groups regarding state- trait anxiety before the intervention. After the first NICU visit, a significant reduction in maternal state anxiety was seen in the both experiment groups. There was no statistical significant difference regarding trait anxiety. Data obtained from Cattell's anxiety questionnaire after intervention, showed significant difference in state anxiety between groups. Conclusion: Employing film and booklet orientation strategy after preterm delivery can reduce the mother’s anxiety and beneficent for the mother, baby, family and health care system.

  9. Transitions: A Mental Health Literacy Program for Postsecondary Students

    Science.gov (United States)

    Potvin-Boucher, Jacqueline; Szumilas, Magdalena; Sheikh, Tabinda; Kutcher, Stan

    2010-01-01

    Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions…

  10. Transitions: A Mental Health Literacy Program for Postsecondary Students

    Science.gov (United States)

    Potvin-Boucher, Jacqueline; Szumilas, Magdalena; Sheikh, Tabinda; Kutcher, Stan

    2010-01-01

    Enhancement of mental health literacy is a mental health promotion strategy that may be effective at destigmatizing mental illness and increasing self-seeking behavior. Transitions is a mental health literacy program intended to heighten students' awareness and discussion of mental health problems and promote help-seeking behaviors. Transitions…

  11. SHPPS 2006: School Health Policies and Programs Study--Asthma

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels. This brief contains information on asthma relative to health education, physical education and activity, and health services. Included is data on the…

  12. Migrant Health Program. [New Jersey] 1970 Annual Report.

    Science.gov (United States)

    New Jersey State Dept. of Health, Trenton.

    During 1970, 3 federally supported migrant health projects continued to serve New Jersey's migrant workers with comprehensive health care. In the 7 counties of principal migrant activity, 4,464 patients received health services. This group represented more than 60% of the noncontract workers. Migrant health programs in Burlington, Gloucester,…

  13. The Association Between Health Program Participation and Employee Retention.

    Science.gov (United States)

    Mitchell, Rebecca J; Ozminkowski, Ronald J; Hartley, Stephen K

    2016-09-01

    Using health plan membership as a proxy for employee retention, the objective of this study was to examine whether use of health promotion programs was associated with employee retention. Propensity score weighted generalized linear regression models were used to estimate the association between telephonic programs or health risk surveys and retention. Analyses were conducted with six study samples based on type of program participation. Retention rates were highest for employees with either telephonic program activity or health risk surveys and lowest for employees who did not participate in any interventions. Participants ranged from 71% more likely to 5% less likely to remain with their employers compared with nonparticipants, depending on the sample used in analyses. Using health promotion programs in combination with health risk surveys may lead to improvements in employee retention.

  14. Pharmacy assistance programs in a community health center setting.

    Science.gov (United States)

    Torres, Maxsimo C; Herman, Debra; Montano, Seferino; Love, Leah

    2002-12-01

    Prescription drug costs represent the fastest growing item in health care and are a driving force in rapidly increasing health care costs. Community health centers serve an indigent population with limited access to pharmaceuticals. Pharmaceutical companies sponsor patient assistance programs. These pharmacy assistance programs can be developed to facilitate the provision of needed pharmaceuticals to this vulnerable population. La Casa de Buena Salud is a rural community health center in eastern New Mexico, which has provided access to a substantial amount of pharmaceuticals to indigent patients through patient assistance programs. Cost savings potential are considerable for a community health center and for patients when a pharmacy assistance program is organized efficiently and employed systematically. Secondary benefits are derived from the entire medical community. While some community health centers currently make effective use of pharmaceutical company-sponsored pharmacy assistance programs, a comprehensive, long-term approach at a national level may be required.

  15. Improving Diabetes Care and Health Measures among Hispanics Using Community Health Workers: Results from a Randomized Controlled Trial

    Science.gov (United States)

    Babamoto, Kenneth S.; Sey, Kwa A.; Camilleri, Angela J.; Karlan, Vicki J.; Catalasan, Joana; Morisky, Donald E.

    2009-01-01

    The increasing prevalence of diabetes and obesity, growing health disparities, and shortage of bilingual and culturally trained health care professionals underscore the role of trained community health workers (CHWs) to provide economically sustainable and culturally relevant services. This prospective randomized design evaluated the relative…

  16. 77 FR 13697 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program-Stage 2

    Science.gov (United States)

    2012-03-07

    ... 42 CFR Parts 412, 413, and 495 Medicare and Medicaid Programs; Electronic Health Record Incentive... CFR Parts 412, 413, and 495 RIN 0938-AQ84 Medicare and Medicaid Programs; Electronic Health Record... Medicaid electronic health record (EHR) incentive payments. In addition, it would specify payment...

  17. Enhancing health knowledge, health beliefs, and health behavior in Poland through a health promoting television program series.

    Science.gov (United States)

    Chew, Fiona; Palmer, Sushma; Slonska, Zofia; Subbiah, Kalyani

    2002-01-01

    This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 15) viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.

  18. Evaluation of Parent and Child Enhancement (PACE) Program: Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Lo, Cyrus

    2017-01-01

    Objective: This study examined the efficacy of the Parent and Child Enhancement (PACE) program on child learning, child behavior problems, and parental stress, using randomized controlled trial design, in social services centers. Methods: Eligibility criteria were (1) children aged 2 years at program commencement, (2) low-income, new immigrant, or…

  19. A worksite prevention program for construction workers: Design of a randomized controlled trial

    NARCIS (Netherlands)

    Hengel, K.M.O.; Joling, C.I.; Proper, K.I.; Blatter, B.M.; Bongers, P.M.

    2010-01-01

    Background. A worksite prevention program was developed to promote the work ability of construction workers and thereby prolong a healthy working life. The objective of this paper is to present the design of a randomized controlled trial evaluating the effectiveness of that intervention program comp

  20. Dissonance and Healthy Weight Eating Disorder Prevention Programs: A Randomized Efficacy Trial

    Science.gov (United States)

    Stice, Eric; Shaw, Heather; Burton, Emily; Wade, Emily

    2006-01-01

    In this trial, adolescent girls with body dissatisfaction (N = 481, M age = 17 years) were randomized to an eating disorder prevention program involving dissonance-inducing activities that reduce thin-ideal internalization, a prevention program promoting healthy weight management, an expressive writing control condition, or an assessment-only…

  1. A Randomized Trial of a Multimodal Community-Based Prisoner Reentry Program Emphasizing Substance Abuse Treatment

    Science.gov (United States)

    Grommon, Eric; Davidson, William S., II; Bynum, Timothy S.

    2013-01-01

    Prisoner reentry programs continue to be developed and implemented to ease the process of transition into the community and to curtail fiscal pressures. This study describes and provides relapse and recidivism outcome findings related to a randomized trial evaluating a multimodal, community-based reentry program that prioritized substance abuse…

  2. Randomized Solutions to Convex Programs with Multiple Chance Constraints

    CERN Document Server

    Schildbach, Georg; Morari, Manfred

    2012-01-01

    Optimization is ubiquitous in modern problems of engineering and science, and in many cases it comes along with some uncertainty about the system or model underlying the problem at hand. A large variety of approaches for handling uncertainty have been proposed in the areas of robust and stochastic optimization, of which the formulation of chance-constraints has proven to be an appropriate concept for many practical applications. Yet chance-constrained optimization programs are generally difficult to solve. The scenario approach provides an intuitive way of approximating the solution to chance-constrained optimization programs, based on finding an optimal solution under a finite number of sampled outcomes of the uncertainty (`scenarios'). A key merit of this approach is that it neither requires knowledge of an uncertainty set, as it is common in robust optimization, nor of a probability distribution, as it is usually assumed in stochastic optimization. Recent research has obtained a strong theoretical foundati...

  3. Incentives: Getting and Keeping Workers Involved in Health Promotion Programs.

    Science.gov (United States)

    McKenzie, James F.; And Others

    1992-01-01

    The article explores motivation as it relates to worksite health promotion participation, addressing incentive use as a motivational means of getting and keeping employees involved in health promotion programs. It suggests various incentives to help program planners, categorizing them as social or material reinforcers. (SM)

  4. Directory of Academic Programs in Occupational Safety and Health.

    Science.gov (United States)

    Weis, William J., III; And Others

    This booklet describes academic program offerings in American colleges and universities in the area of occupational safety and health. Programs are divided into five major categories, corresponding to each of the core disciplines: (1) occupational safety and health/industrial hygiene, (2) occupational safety, (3) industrial hygiene, (4)…

  5. Overview and Summary: School Health Policies and Programs Study 2006

    Science.gov (United States)

    Kann, Laura; Brener, Nancy D.; Wechsler, Howell

    2007-01-01

    Background: The School Health Policies and Programs Study (SHPPS) 2006 is the largest, most comprehensive assessment of school health programs in the United States ever conducted. Methods: The Centers for Disease Control and Prevention conducts SHPPS every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail…

  6. An assessment of health behavior peer effects in Peking University dormitories: a randomized cluster-assignment design for interference.

    Science.gov (United States)

    Yuan, Changzheng; Lv, Jun; VanderWeele, Tyler J

    2013-01-01

    Relatively little is known about the peer influence in health behaviors within university dormitory rooms. Moreover, in China, the problem of unhealthy behaviors among university students has not yet been sufficiently recognized. We thus investigated health behavior peer influence in Peking University dormitories utilizing a randomized cluster-assignment design. Cross-sectional in-dormitory survey. Current students from Peking University Health Science Center from April to June, 2009. Self-reported questionnaire on health behaviors: physical activity (including bicycling), dietary intake and tobacco use. Use of bicycle, moderate-intensity exercise, frequency of sweet food and soybean milk intake, frequency of roasted/baked/toasted food intake were behaviors significantly or marginally significantly affected by peer influence. Health behavior peer effects exist within dormitory rooms among university students. This could provide guidance on room assignment, or inform intervention programs. Examining these may demand attention from university administrators and policy makers.

  7. Random harmonic analysis program, L221 (TEV156). Volume 1: Engineering and usage

    Science.gov (United States)

    Miller, R. D.; Graham, M. L.

    1979-01-01

    A digital computer program capable of calculating steady state solutions for linear second order differential equations due to sinusoidal forcing functions is described. The field of application of the program, the analysis of airplane response and loads due to continuous random air turbulence, is discussed. Optional capabilities including frequency dependent input matrices, feedback damping, gradual gust penetration, multiple excitation forcing functions, and a static elastic solution are described. Program usage and a description of the analysis used are presented.

  8. Consideration of an applied model of public health program infrastructure.

    Science.gov (United States)

    Lavinghouze, René; Snyder, Kimberly; Rieker, Patricia; Ottoson, Judith

    2013-01-01

    Systemic infrastructure is key to public health achievements. Individual public health program infrastructure feeds into this larger system. Although program infrastructure is rarely defined, it needs to be operationalized for effective implementation and evaluation. The Ecological Model of Infrastructure (EMI) is one approach to defining program infrastructure. The EMI consists of 5 core (Leadership, Partnerships, State Plans, Engaged Data, and Managed Resources) and 2 supporting (Strategic Understanding and Tactical Action) elements that are enveloped in a program's context. We conducted a literature search across public health programs to determine support for the EMI. Four of the core elements were consistently addressed, and the other EMI elements were intermittently addressed. The EMI provides an initial and partial model for understanding program infrastructure, but additional work is needed to identify evidence-based indicators of infrastructure elements that can be used to measure success and link infrastructure to public health outcomes, capacity, and sustainability.

  9. Sexual Health Education in Massage Therapy Programs: A Survey of Program Directors

    Science.gov (United States)

    Zamboni, Brian D.; Healey, Dale K.

    2016-01-01

    Massage therapy program directors completed an online survey to explore sexual education in massage therapy programs. The overall data suggest that program directors are supportive of sexual health education in the training of massage therapists and that such education is integrated into several aspects of their training programs. To enhance…

  10. 76 FR 67743 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2011-11-02

    ... Medicare or Medicaid programs or Children's Health Insurance Program (CHIP); revalidating their Medicare... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment..., Medicaid, and Children's Health Insurance Program (CHIP) provider enrollment processes. Specifically, and...

  11. Evaluation of the mental health benefits of yoga in a secondary school: a preliminary randomized controlled trial.

    Science.gov (United States)

    Khalsa, Sat Bir S; Hickey-Schultz, Lynn; Cohen, Deborah; Steiner, Naomi; Cope, Stephen

    2012-01-01

    The goal of this study was to evaluate potential mental health benefits of yoga for adolescents in secondary school. Students were randomly assigned to either regular physical education classes or to 11 weeks of yoga sessions based upon the Yoga Ed program over a single semester. Students completed baseline and end-program self-report measures of mood, anxiety, perceived stress, resilience, and other mental health variables. Independent evaluation of individual outcome measures revealed that yoga participants showed statistically significant differences over time relative to controls on measures of anger control and fatigue/inertia. Most outcome measures exhibited a pattern of worsening in the control group over time, whereas changes in the yoga group over time were either minimal or showed slight improvements. These preliminary results suggest that implementation of yoga is acceptable and feasible in a secondary school setting and has the potential of playing a protective or preventive role in maintaining mental health.

  12. 42 CFR 457.618 - Ten percent limit on certain Children's Health Insurance Program expenditures.

    Science.gov (United States)

    2010-10-01

    ... Insurance Program expenditures. 457.618 Section 457.618 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS... Children's Health Insurance Program expenditures. (a) Expenditures. (1) Primary expenditures are...

  13. 75 FR 58203 - Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

    Science.gov (United States)

    2010-09-23

    .... Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment... requirement for participation as a provider of health care services under a Federal health care program that...

  14. Effectiveness of a Multi-Component Intervention for Overweight and Obese Children (Nereu Program: A Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Noemi Serra-Paya

    Full Text Available Treatment of childhood obesity is a complex challenge for primary health care professionals.To evaluate the effectiveness of the Nereu Program in improving anthropometric parameters, physical activity and sedentary behaviours, and dietary intake.Randomized, controlled, multicentre clinical trial comparing Nereu Program and usual counselling group interventions in primary care settings. The 8-month study recruited 113 children aged 6 to 12 years with overweight/obesity. Before recruitment, eligible participants were randomly allocated to an intensive, family-based multi-component behavioural intervention (Nereu Program group or usual advice from their paediatrician on healthy eating and physical activity. Anthropometric parameters, objectively measured sedentary and physical activity behaviours, and dietary intake were evaluated pre- and post-intervention.At the end of the study period, both groups achieved a similar decrease in body mass index (BMIsd compared to baseline. Nereu Program participants (n = 54 showed greater increases in moderate-intense physical activity (+6.27% vs. -0.61%, p<0.001 and daily fruit servings (+0.62 vs. +0.13, p<0.026, and decreased daily soft drinks consumption (-0.26 vs. -0.02, p<0.047, respectively, compared to the counselling group (n = 59.At the end of the 8-month intervention, participants in the Nereu Program group showed improvement in physical activity and dietary behaviours, compared to the counselling group.ClinicalTrials.gov NCT01878994.

  15. Effectiveness of a Multi-Component Intervention for Overweight and Obese Children (Nereu Program): A Randomized Controlled Trial

    Science.gov (United States)

    Serra-Paya, Noemi; Ensenyat, Assumpta; Castro-Viñuales, Iván; Real, Jordi; Sinfreu-Bergués, Xènia; Zapata, Amalia; Mur, Jose María; Galindo-Ortego, Gisela; Solé-Mir, Eduard; Teixido, Concepció

    2015-01-01

    Introduction Treatment of childhood obesity is a complex challenge for primary health care professionals. Objectives To evaluate the effectiveness of the Nereu Program in improving anthropometric parameters, physical activity and sedentary behaviours, and dietary intake. Methods Randomized, controlled, multicentre clinical trial comparing Nereu Program and usual counselling group interventions in primary care settings. The 8-month study recruited 113 children aged 6 to 12 years with overweight/obesity. Before recruitment, eligible participants were randomly allocated to an intensive, family-based multi-component behavioural intervention (Nereu Program group) or usual advice from their paediatrician on healthy eating and physical activity. Anthropometric parameters, objectively measured sedentary and physical activity behaviours, and dietary intake were evaluated pre- and post-intervention. Results At the end of the study period, both groups achieved a similar decrease in body mass index (BMIsd) compared to baseline. Nereu Program participants (n = 54) showed greater increases in moderate-intense physical activity (+6.27% vs. -0.61%, p<0.001) and daily fruit servings (+0.62 vs. +0.13, p<0.026), and decreased daily soft drinks consumption (-0.26 vs. -0.02, p<0.047), respectively, compared to the counselling group (n = 59). Conclusions At the end of the 8-month intervention, participants in the Nereu Program group showed improvement in physical activity and dietary behaviours, compared to the counselling group. Trial Registration ClinicalTrials.gov NCT01878994 PMID:26658988

  16. Fluoride Programs in the School Setting: Preventive Dental Health.

    Science.gov (United States)

    Rebich, Theodore, Jr.; And Others

    1982-01-01

    Two types of school-based programs that increase students' use of fluoride for preventive dental health are described. In fluoride mouthrinse programs, teachers give their students a fluoride solution once a week in a paper cup. In areas where the level of fluoride in the water supply is insufficient, the flouride tablet program is used. (JN)

  17. Co-responding Police-Mental Health Programs: A Review.

    Science.gov (United States)

    Shapiro, G K; Cusi, A; Kirst, M; O'Campo, P; Nakhost, A; Stergiopoulos, V

    2015-09-01

    Co-responding police-mental health programs are increasingly used to respond to 'Emotionally Disturbed Persons' in the community; however, there is limited understanding of program effectiveness and the mechanisms that promote program success. The academic and gray literature on co-responding police-mental health programs was reviewed. This review synthesized evidence of outcomes along seven dimensions, and the available evidence was further reviewed to identify potential mechanisms of program success. Co-responding police-mental health programs were found to have strong linkages with community services and reduce pressure on the justice system, but there is limited evidence on other impacts. The relevance of these findings for practitioners and the major challenges of this program model are discussed, and future research directions are identified.

  18. Personal Benefits of a Health Evaluation and Enhancement Program

    Science.gov (United States)

    Heinzelmann, F.; Durbeck, D. C.

    1970-01-01

    A study was made of the benefits reported by participants in a health evaluation and enhancement program dealing with physical activity. Program benefits were identified and defined in regard to three major areas: program effects on work; program effects on health; and program effects on habits and behavior. A strong positive and consistent relationship was found between reported benefits in each of these areas and measures of improvement in cardiovascular functioning based on treadmill performance. Significant differences in these measures of improvement were also found between participants who reported program benefits and those persons who did not. These findings provide a meaningful profile of the pattern of benefits generated by this kind of health program.

  19. The Relationship between School Health Councils and School Health Policies and Programs in US Schools

    Science.gov (United States)

    Brener, Nancy D.; Kann, Laura; McManus, Tim; Stevenson, Beth; Wooley, Susan F.

    2004-01-01

    This study analyzed data from the School Health Policies and Programs Study (SHPPS) 2000 to examine the relationship between school health councils and selected school health policies and programs. SHPPS 2000 collected data from faculty and staff in a nationally representative sample of schools. About two-thirds (65.7%) of US schools have school…

  20. Evaluation of three adolescent sexual health programs in ha noi and khanh hoa province, Vietnam.

    Science.gov (United States)

    Pham, Van; Nguyen, Hoang; Tho, Le Huu; Minh, Truong Tan; Lerdboon, Porntip; Riel, Rosemary; Green, Mackenzie S; Kaljee, Linda M

    2012-01-01

    With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT) was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15-20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK), the gender-based program Exploring the World of Adolescents (EWA), and EWA plus parental and health provider education (EWA+). Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+) compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents.

  1. Evaluation of Three Adolescent Sexual Health Programs in Ha Noi and Khanh Hoa Province, Vietnam

    Directory of Open Access Journals (Sweden)

    Van Pham

    2012-01-01

    Full Text Available With an increase in sexual activity among young adults in Vietnam and associated risks, there is a need for evidence-based sexual health interventions. This evaluation of three sexual health programs based on the Protection Motivation Theory (PMT was conducted in 12 communes in Ha Noi, Nha Trang City, and Ninh Hoa District. Inclusion criteria included unmarried youth 15–20 years residing in selected communes. Communes were randomly allocated to an intervention, and participants were randomly selected within each commune. The intervention programs included Vietnamese Focus on Kids (VFOK, the gender-based program Exploring the World of Adolescents (EWA, and EWA plus parental and health provider education (EWA+. Programs were delivered over a ten-week period in the communities by locally trained facilitators. The gender-based EWA program with parental involvement (EWA+ compared to VFOK showed significantly greater increase in knowledge. EWA+ in comparison to VFOK also showed significant decrease at immediate postintervention for intention to have sex. Sustained changes are observed in all three interventions for self-efficacy condom use, self-efficacy abstinence, response efficacy for condoms, extrinsic rewards, and perceived vulnerability for HIV. These findings suggest that theory-based community programs contribute to sustained changes in knowledge and attitudes regarding sexual risk among Vietnamese adolescents.

  2. The evolution of health programming on cable television.

    Science.gov (United States)

    Banks, M J; Banks, M E

    1988-01-01

    Health-oriented television programming occurred only on a sporadic basis until 1982, when a health information project was embodied in the formation of the Cable Health Network (CHN), a 24-hour, advertiser-supported, satellite-delivered cable network. As the network began, however, it ran into difficulties. A series of events led to a metamorphosis, including a merger of CHN with ABC/Hearst's network Daytime into the Lifetime network. A gradual but substantial replacement of health programming with more general entertainment fare took place. The network has enjoyed greater financial success in recent times, but success has come considerably at the expense of the health component, even though health promotion remains an important part of the programming. The study supports the suggestion by some researchers that the impact of mass media health promotion should be studied in the context of lifestyle and audience usage, rather than strictly as a linear message-audience-effect model.

  3. AAHD's Health Promotion and Wellness, Part 2: Health Promotion Programs

    Science.gov (United States)

    Exceptional Parent, 2011

    2011-01-01

    This article is part 2 of a 4-part series on "Health Promotion and Wellness" from the American Association on Health and Disability (AAHD). According to the U.S. Census Bureau, more than 54 million people--one in five Americans--have a disability, and these Americans are more likely to report: (1) Being in poorer overall health; (2) Having less…

  4. Program Models for Mental Health Treatment of Refugees.

    Science.gov (United States)

    Jaranson, James M.; Bamford, Pauline

    This paper presents the approach used by the Technical Assistance Center (TAC) of the University of Minnesota's Refugee Assistance Program in Mental Health for identifying successful and culturally sensitive mental health service delivery models. It divides these into four categories: the psychiatric model; the community mental health model; the…

  5. Leading by Example: Health Promotion Programs for School Staff

    Science.gov (United States)

    Herbert, Patrick C.; Lohrmann, David K.

    2011-01-01

    Health promotion programs for school staff are an overlooked and underused resource that can reduce overweight and obesity among teachers and other staff members. They can also reduce staff absenteeism, increase productivity, reduce costs associated with health care and disability, and foster a climate that promotes good health schoolwide. An…

  6. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    Science.gov (United States)

    Nix, Mary P.

    2009-01-01

    There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…

  7. The economic impact of adolescent health promotion policies and programs.

    Science.gov (United States)

    Aratani, Yumiko; Schwarz, Susan Wile; Skinner, Curtis

    2011-12-01

    Adolescence is a critical period in the human lifecycle, a time of rapid physical and socioemotional growth and a time when individuals establish lifestyle habits and health behaviors that often endure into and have lasting effects in adulthood. Adolescent health promotion programs play a critical role in helping youth establish healthy lifestyles. In this article, we present a socio-ecological model as a framework for identifying effective policy and program areas that have a positive impact on adolescent health behaviors. Our discussion focuses on 4 key areas: reproductive health; obesity prevention; mental health and substance use, including smoking; and injury and violence prevention. We proceed with an overview of the current status of state-led adolescent health promotion policies and programs from a newly created policy database and then examine the evidence on the cost of preventable adolescent health problems and the cost-effectiveness of health promotion programs and policies. We conclude by discussing the threat posed to adolescent health promotion services and state-led policy initiatives by proposed and implemented federal and state-level budget cuts and examine the possible health and economic repercussions of reducing or eliminating these programs.

  8. Effects of resource-building group intervention on career management and mental health in work organizations: randomized controlled field trial.

    Science.gov (United States)

    Vuori, Jukka; Toppinen-Tanner, Salla; Mutanen, Pertti

    2012-03-01

    A resource-building group intervention was developed to enhance career management, mental health, and job retention in work organizations. The in-company training program provided employees with better preparedness to manage their own careers. The program activities were universally implemented using an organization-level, 2-trainer model with trainers from the human resources management and occupational health services. The study was a within-organizations, randomly assigned field experimental study; it investigated the impacts of the intervention on immediate career management preparedness and later mental health and intentions to retire early. A total of 718 eligible individuals returned a questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either an intervention (N = 369) or a comparison group (N = 349). Those in the intervention group were invited to group intervention workshops, whereas those in the comparison group received printed information about career and health-related issues. The 7-month follow-up results showed that the program significantly decreased depressive symptoms and intentions to retire early and increased mental resources among the group participants compared to the others. The mediation analyses demonstrated that the increase in career management preparedness as a proximal impact of the intervention mediated the longer term mental health effects. Those who benefited most from the intervention as regards their mental health were employees with elevated levels of depression or exhaustion and younger employees, implying additional benefits of a more targeted use of the intervention. The results demonstrated the benefits of the enhancement of individual-level career management and resilience resources as career and health promotion practice in work organizations.

  9. Coordinated school health program and dietetics professionals: partners in promoting healthful eating.

    Science.gov (United States)

    Gross, Sandra M; Cinelli, Bethann

    2004-05-01

    Although research indicates that school meal programs contribute to improved academic performance and healthier eating behaviors for students who participate, fewer than 60% of students choose the National School Lunch Program or School Breakfast Program. School meal programs have a difficult time competing with foods that are marketed to young people through sophisticated advertising campaigns. Youth's preferences for fast foods, soft drinks, and salty snacks; mixed messages sent by school personnel; school food preparation and serving space limitations; inadequate meal periods; and lack of education standards for school foodservice directors challenge school meal programs as well. A coordinated school health program offers a framework for meeting these challenges and provides children and adolescents with the knowledge and skills necessary for healthful eating. This article identifies challenges facing school foodservice directors in delivering healthful meals and acquaints dietetics professionals with the coordinated school health program to be used as a tool for addressing unhealthful weight gain and promoting healthful eating.

  10. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...... municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should...

  11. A residents' program for educating adolescents about mental health issues.

    Science.gov (United States)

    Coverdale, J H; Battaglia, J; Bushong, C P

    1991-09-01

    This paper describes a school-based program in which psychiatry residents educate adolescents about a variety of mental health topics. Adolescents responded positively to the program and were principally concerned about drugs, depression, suicide, and family problems. Residents also liked presenting in the schools. Participation in this program allowed residents to learn about agency consultation and secondary prevention. Possibilities for program expansion are discussed.

  12. A Regional Public Health Field Placement Program: making an IMPACT.

    Science.gov (United States)

    McCormick, Lisa C; Hites, Lisle; Jenkins, Crystal; Chauvin, Sheila W; Rucks, Andrew C; Ginter, Peter M

    2014-03-01

    Beginning in 2010, the U.S. Department of Health and Human Services, Health Resources and Services Administration, made provisions in its Public Health Training Center cooperative agreements for field placements. This article describes best practices and lessons learned establishing and managing the South Central Public Health Partnership's Interns and Mentors Program for ACTion (IMPACT) Field Placement Program, which was initially funded through the Centers for Disease Control and Prevention's Centers for Public Health Preparedness Cooperative agreement in 2002. The IMPACT program is based on a six-step process that has been developed and refined over its 10-year history: (a) identifying field placement opportunities, (b) marketing field experience opportunities to students, (c) selecting students seeking field experience opportunities, (d) placing students with practice partners, students with practice partners, (e) evaluating student progress toward field experience objectives, and (f) evaluating the program. This article describes the program's structure and processes, delineates the roles of its academic and practice partners, discusses evidence of its effectiveness, and describes lessons learned from its decade-long history. Hopefully, this information will facilitate the establishment, management and evaluation of internship and field placement programs in other Public Health Training Centers and academic public health programs.

  13. Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial.

    Science.gov (United States)

    da Silva, Flávio S; de Melo, Flávio E S; do Amaral, Marcelo M G; Caldas, Vinícius V A; Pinheiro, Íria Lúcia D; Abreu, Bento J; Vieira, Wouber H

    2015-01-01

    We investigated the role of an evidence-based integrated group rehabilitation program on the treatment of patients with knee osteoarthritis (KOA). This was a two-group, randomized controlled, 8 wk trial with 41 patients with moderate to very severe KOA. Patients were assigned to an intervention group (IG) or control group (CG). After both groups had received a self-management education program, IG participants underwent a rehabilitation program, including educational aspects about KOA followed by exercises. CG participants received only general health orientation about KOA during this period. The outcome measures were the Lequesne algofunctional index; 36-Item Short Form Health Survey (SF-36); and chair-stand, sit-and-reach, timed up-and-go, and 6-minute walk tests. Analysis of covariance revealed significant postintervention improvements of IG participants compared with CG participants (p program reduced pain and improved quality of life and function in patients with KOA. ClinicalTrials.gov; Progressive Collective-exercise Program on the Knee Osteoarthritis; NCT01850862; https://clinicaltrials.gov/ct2/show/NCT01850862?term=NCT01850862&rank=1.

  14. Healthy Learning Mind - a school-based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial.

    Science.gov (United States)

    Volanen, Salla-Maarit; Lassander, Maarit; Hankonen, Nelli; Santalahti, Päivi; Hintsanen, Mirka; Simonsen, Nina; Raevuori, Anu; Mullola, Sari; Vahlberg, Tero; But, Anna; Suominen, Sakari

    2016-07-11

    Mindfulness has shown positive effects on mental health, mental capacity and well-being among adult population. Among children and adolescents, previous research on the effectiveness of mindfulness interventions on health and well-being has shown promising results, but studies with methodologically sound designs have been called for. Few intervention studies in this population have compared the effectiveness of mindfulness programs to alternative intervention programs with adequate sample sizes. Our primary aim is to explore the effectiveness of a school-based mindfulness intervention program compared to a standard relaxation program among a non-clinical children and adolescent sample, and a non-treatment control group in school context. In this study, we systematically examine the effects of mindfulness intervention on mental well-being (primary outcomes being resilience; existence/absence of depressive symptoms; experienced psychological strengths and difficulties), cognitive functions, psychophysiological responses, academic achievements, and motivational determinants of practicing mindfulness. The design is a cluster randomized controlled trial with three arms (mindfulness intervention group, active control group, non-treatment group) and the sample includes 59 Finnish schools and approx. 3 000 students aged 12-15 years. Intervention consists of nine mindfulness based lessons, 45 mins per week, for 9 weeks, the dose being identical in active control group receiving standard relaxation program called Relax. The programs are delivered by 14 educated facilitators. Students, their teachers and parents will fill-in the research questionnaires before and after the intervention, and they will all be followed up 6 months after baseline. Additionally, students will be followed 12 months after baseline. For longer follow-up, consent to linking the data to the main health registers has been asked from students and their parents. The present study examines

  15. Evaluation of occupational health interventions using a randomized controlled trial: challenges and alternative research designs

    NARCIS (Netherlands)

    Schelvis, R.M; Oude Hengel, K.M.; Burdorf, A.; Blatter, B.M.; Strijk, J.E.; Beek, A.J. van

    2015-01-01

    Occupational health researchers regularly conduct evaluative intervention research for which a randomized controlled trial (RCT) may not be the most appropriate design (eg, effects of policy measures, organizational interventions on work schedules). This article demonstrates the appropriateness of a

  16. A safety awareness program for women with diverse disabilities: a randomized controlled trial.

    Science.gov (United States)

    Robinson-Whelen, Susan; Hughes, Rosemary B; Gabrielli, Joy; Lund, Emily M; Abramson, Wendie; Swank, Paul R

    2014-07-01

    Women with diverse disabilities (N = 213), recruited through 10 centers for independent living (CILs), were randomly assigned to either a personal safety awareness program or usual care. The 8-week program, led by CIL staff, was designed to increase safety awareness, abuse and safety knowledge, safety skills, safety self-efficacy, social support, and safety promoting behaviors. All participants completed pre-, post-, and 6-month follow-up questionnaires. Results revealed that participation in a brief safety awareness program may improve safety protective factors among women with disabilities who vary widely in their experience with abuse. The program holds promise for enhancing safety among women with disabilities. © The Author(s) 2014.

  17. The VA Maryland Health Care System's telemental health program.

    Science.gov (United States)

    Koch, Edward F

    2012-05-01

    The VA Maryland Health Care System introduced videoconferencing technology to provide psychiatry, evidenced-based psychotherapy, case management, and patient education at rural clinics where it was difficult to recruit providers. Telemental health services enable rural clinics to offer additional services, such as case management and patient education. Services have been expanded to urban outpatient clinics where a limited number of mental health clinic hours are available. This technology expands the availability of mental health providers and services, allowing patients to receive services from providers located at distant medical centers.

  18. Evaluation of the Health Rocks! Program: The Association of Youth Engagement with Program Outcomes

    Directory of Open Access Journals (Sweden)

    Yan Xia

    2017-01-01

    Full Text Available This evaluation research examined the relationship between program process and program outcome, specifically, youth engagement in the national 4-H Council Health Rocks! program and their program outcomes.  Based on program evaluation surveys completed after the program by participants, youths’ engagement in the program was associated with their gains in knowledge and skills about substance use, and personal assets related to avoiding risks.  When youth participants find a program interesting, are actively engaged in the program, and find the program staff friendly, they benefit more from the program.  Findings underscore the importance of engaging curriculum and friendly staff to the success of extension or afterschool youth programs. The evaluation method may offer an example of balancing rigor of evaluation design and feasibility of implementing an evaluation.

  19. A new neural network model for solving random interval linear programming problems.

    Science.gov (United States)

    Arjmandzadeh, Ziba; Safi, Mohammadreza; Nazemi, Alireza

    2017-05-01

    This paper presents a neural network model for solving random interval linear programming problems. The original problem involving random interval variable coefficients is first transformed into an equivalent convex second order cone programming problem. A neural network model is then constructed for solving the obtained convex second order cone problem. Employing Lyapunov function approach, it is also shown that the proposed neural network model is stable in the sense of Lyapunov and it is globally convergent to an exact satisfactory solution of the original problem. Several illustrative examples are solved in support of this technique.

  20. Institutional lessons learned in environmental health programs

    NARCIS (Netherlands)

    O'Toole, Lawrence J.; Sencer, David J.

    1999-01-01

    During the last four years, the Environmental Health Project (EHP) has been engaged in a wide range of environmental health activities, many of which have had an institutional component. While some were specifically designated as institutional development activities, a number of them were focused pr

  1. Institutional lessons learned in environmental health programs

    NARCIS (Netherlands)

    O'Toole, Laurence J.; Sencer, David J.

    1999-01-01

    During the last four years, the Environmental Health Project (EHP) has been engaged in a wide range of environmental health activities, many of which have had an institutional component. While some were specifically designated as institutional development activities, a number of them were focused

  2. The effect of community-based health management on the health of the elderly: a randomized controlled trial from China

    Directory of Open Access Journals (Sweden)

    Chao Jianqian

    2012-12-01

    Full Text Available Abstract Background An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. Methods Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. Results Compared with the control group, the management group demonstrated improvement on the following variables (P Conclusion Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. Trial registration ChiCTR-OCH-11001716

  3. Building health systems capacity in global health graduate programs: reflections from Australian educators.

    Science.gov (United States)

    Negin, Joel; Martiniuk, Alexandra; Morgan, Chris; Davies, Philip; Zwi, Anthony

    2012-08-24

    There has been increasing focus on the role of health systems in low and middle-income countries. Despite this, very little evidence exists on how best to build health systems program and research capacity in educational programs. The current experiences in building capacity in health systems in five of the most prominent global health programs at Australian universities are outlined. The strengths and weaknesses of various approaches and techniques are provided along with examples of global practice in order to provide a foundation for future discussion and thus improvements in global health systems education.

  4. The PLE(2)NO self-management and exercise program for knee osteoarthritis: Study Protocol for a Randomized Controlled Trial.

    Science.gov (United States)

    Marconcin, Priscila; Espanha, Margarida; Yázigi, Flávia; Campos, Pedro

    2016-06-07

    International recommendations suggest exercise and self-management programs, including non-pharmacological treatments, for knee osteoarthritis (KOA) because they can benefit pain relief and improve function and exercise adherence. The implementation of a combined self-management and exercise program termed PLE(2)NO may be a good method for controlling KOA symptoms because it encourages the development of self-efficacy to manage the pathology. This study will assess the effects of a self-management and exercise program in comparison to an educational intervention (control program) on symptoms, physical fitness, health-related quality of life, self-management behaviors, self-efficacy, physical activity level and coping strategies. This PLE(2)NO study is a single-blinded, randomized controlled trial of elderly (aged above 60 yrs old) patients with clinical and radiographic KOA. The patients will be allocated into either an educational group (control) or a self-management and exercise group (experimental). All participants will receive a supplement of chondroitin and glucosamine sulfates. This paper describes the protocol that will be used in the PLE(2)NO program. This program has several strengths. First, it involves a combination of self-management and exercise approaches, is available in close proximity to the patients and occurs over a short period of time. The latter two characteristics are crucial for maintaining participant adherence. Exercise components will be implemented using low-cost resources that permit their widespread application. Moreover, the program will provide guidance regarding the effectiveness of using a self-management and exercise program to control KOA symptoms and improve self-efficacy and health-related quality of life. NCT02562833 (09/23/2015).

  5. Comparing rating paradigms for evidence-based program registers in behavioral health: evidentiary criteria and implications for assessing programs.

    Science.gov (United States)

    Means, Stephanie N; Magura, Stephen; Burkhardt, Jason T; Schröter, Daniela C; Coryn, Chris L S

    2015-02-01

    Decision makers need timely and credible information about the effectiveness of behavioral health interventions. Online evidence-based program registers (EBPRs) have been developed to address this need. However, the methods by which these registers determine programs and practices as being “evidence-based” has not been investigated in detail. This paper examines the evidentiary criteria EBPRs use to rate programs and the implications for how different registers rate the same programs. Although the registers tend to employ a standard Campbellian hierarchy of evidence to assess evaluation results, there is also considerable disagreement among the registers about what constitutes an adequate research design and sufficient data for designating a program as evidence-based. Additionally, differences exist in how registers report findings of “no effect,” which may deprive users of important information. Of all programs on the 15 registers that rate individual programs, 79% appear on only one register. Among a random sample of 100 programs rated by more than one register, 42% were inconsistently rated by the multiple registers to some degree.

  6. Sri Lanka's Health Unit Program: A Model of "Selective" Primary Health Care

    Directory of Open Access Journals (Sweden)

    Soma Hewa

    2011-12-01

    Full Text Available This paper argues that the health unit program developed in Sri Lanka in the early twentieth century was an earlier model of selective primary health care promoted by the Rockefeller Foundation in the 1980s in opposition to comprehensive primary health care advocated by the Alma-Ata Declaration of the World Health Organization. A key strategy of the health unit program was to identify the most common and serious infectious diseases in each health unit area and control them through improved sanitation, health education, immunization and treatment with the help of local communities. The health unit program was later introduced to other countries in South and Southeast Asia as part of the Rockefeller Foundation's global campaign to promote public health.

  7. Selecting, adapting, and sustaining programs in health care systems

    Directory of Open Access Journals (Sweden)

    Zullig LL

    2015-04-01

    Full Text Available Leah L Zullig,1,2 Hayden B Bosworth1–4 1Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 2Department of Medicine, Duke University Medical Center, Durham, NC, USA; 3School of Nursing, 4Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA Abstract: Practitioners and researchers often design behavioral programs that are effective for a specific population or problem. Despite their success in a controlled setting, relatively few programs are scaled up and implemented in health care systems. Planning for scale-up is a critical, yet often overlooked, element in the process of program design. Equally as important is understanding how to select a program that has already been developed, and adapt and implement the program to meet specific organizational goals. This adaptation and implementation requires attention to organizational goals, available resources, and program cost. We assert that translational behavioral medicine necessitates expanding successful programs beyond a stand-alone research study. This paper describes key factors to consider when selecting, adapting, and sustaining programs for scale-up in large health care systems and applies the Knowledge to Action (KTA Framework to a case study, illustrating knowledge creation and an action cycle of implementation and evaluation activities. Keywords: program sustainability, diffusion of innovation, information dissemination, health services research, intervention studies 

  8. Comprehensive environment, health, and safety program report, FY 1978

    Energy Technology Data Exchange (ETDEWEB)

    1979-02-01

    A description is given of the environment, health, and safety research, development, and demonstration activities carried out and in progress. Discussion is presented under the following section headings: a comprehensive environment, health, and safety program: concept and implementation approach; the DOE Office of Environment - program and selected activities; environmental, health, and safety activities of other DOE offices; and, environmental, health, and safety activities of other federal agencies; titles of the four appendixes are: definition of research categories; summary of energy-related environment, health, and safety concerns; environment, health, and safety laws and regulations governing activities of the Department of Energy; and environmental, health, and safety activities of federal agencies participating in the Federal Inventory. (JGB)

  9. Federal Employees Health Benefits Program (FEHBP) Plan Information

    Data.gov (United States)

    Office of Personnel Management — A list of all Federal Employees Health Benefits Program (FEHBP) plans available in each state, as well as links to the plan brochures, changes for each plan from the...

  10. Proposal for a state health technology assessment program.

    Science.gov (United States)

    Colmenares, Phil

    2012-08-01

    Evidence suggests that a significant number of medical technologies are of little or no benefit to patients. Under current budgetary pressures, state health care programs cannot afford continued spending on unnecessary medical care without further cuts in enrollment. Limiting coverage of high-tech care only to indications supported by good clinical evidence would help save state health care dollars. However, there is currently no public process to formally evaluate new medical interventions in Wisconsin. In fact, new therapies often are introduced into clinical practice, and covered by state health insurance programs, even when there is weak or questionable evidence of clinical effectiveness. This article proposes the creation of a state Health Technology Assessment program in Wisconsin to systematically evaluate new tests or treatments, and to promote evidence-based coverage decisions. Such a program would help limit wasteful spending on unnecessary technologies, reinforce good clinical practice, and protect patients from the risks of interventions that have not been proven effective.

  11. Region 6 Avian Health Program FY2011 Annual Report

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report describes activities and fund allocations of the Region 6 Avian Health Program in FY2011. Activities include morbidity and mortality monitoring, disease...

  12. Applied epidemiology: another tool in dairy herd health programs?

    Science.gov (United States)

    Frankena, K; Noordhuizen, J P; Stassen, E N

    1994-01-01

    Data bases of herd health programs concern data from individual animals mainly. Several parameters that determine herd performance can be calculated from these programs, and by comparing actual values with standard values, areas for further improvement of health (and production) can be advised. However, such advice is usually not backed up by the proper statistical analyses. Moreover, data concerning the environment of the animals are not present and hence advice concerning multifactorial diseases are based on common knowledge and experience. Veterinary epidemiology offers methods that might improve the value of herd health programs by identification and quantification of factors and conditions contributing to multifactorial disease occurrence. Implementation of these methods within herd health programs will lead to more scientifically sound advice.

  13. Smart Choice Health Insurance©: A New, Interdisciplinary Program to Enhance Health Insurance Literacy.

    Science.gov (United States)

    Brown, Virginia; Russell, Mia; Ginter, Amanda; Braun, Bonnie; Little, Lynn; Pippidis, Maria; McCoy, Teresa

    2016-03-01

    Smart Choice Health Insurance© is a consumer education program based on the definition and emerging measurement of health insurance literacy and a review of literature and appropriate theoretical frameworks. An interdisciplinary team of financial and health educators was formed to develop and pilot the program, with the goal of reducing confusion and increasing confidence in the consumer's ability to make a smart health insurance decision. Educators in seven states, certified to teach the program, conducted workshops for 994 consumers. Results show statistically significant evidence of increased health insurance literacy, confidence, and capacity to make a smart choice health insurance choice. Discussion centers on the impact the program had on specific groups, next steps to reach a larger audience, and implications for educators, consumers, and policymakers nationwide. © 2015 Society for Public Health Education.

  14. A comparison of the effectiveness of the "Toothkeeper" and a traditional dental health education program.

    Science.gov (United States)

    Graves, R C; McNeal, D R; Haefner, D P; Ware, B G

    1975-01-01

    A study was made of the effectiveness of two dental health education programs in an elementary school in Flint, Michigan. Following stratification by grades, random assignments of students were made by classrooms to either the Toothkeeper group or a "Traditional" group. No control groups were employed. Separate in-service training workshops were attended by the classroom teachers according to the education program to which they had been randomly assigned. An intensive 16-week program was conducted by the classroom teachers following the guidelines of the two programs. Dental examinations which included an assessment of plaque and gingivitis scores were conducted on all participants at baseline, at the end of 16 weeks, and at the conclusion of the school year, some seven months after the initiation of the program. Only minimal reductions in plaque scores were observed with either program and little comparative difference was found in the two programs at the end of the evaluation period. The Toothkeeper group experienced a somewhat greater reduction in plaque scores than the "Traditional" group during the intensive 16-week phase of the study, but these scores worsened from this time to the end of the school year. Gingivitis scores demonstrated more improvement than the reductions in plaque scores would indicate and may be related to the confounding factor of large numbers of children receiving dental treatment, especially prophylaxes during the course of this study. Differences in reductions in gingivitis between the two programs were not meaningful clinically.

  15. Integrating reproductive health services into family planning programs.

    Science.gov (United States)

    1995-06-01

    A recent Population Council publication, Reproductive Health Approach to Family Planning, discusses integration of reproductive health into family planning programs in a series of edited presentations that Council staff and colleagues gave at a 1994 meeting of the US Agency for International Development (USAID) cooperating agencies. The presentations reflect the Council's view that family planning programs ought to help individuals achieve their own reproductive goals in a healthful manner. The report discusses four areas of reproductive health: reproductive tract infections (RTIs), including sexually transmitted diseases; prevention and treatment of unsafe abortion; pregnancy, labor, and delivery care; and postpartum care. Christopher Elias (Senior Associate, Programs Division) argued that family planning programs ought to provide services that target RTIs, given that these illnesses afflict a significant proportion of reproductive-age women. The family planning community has an ethical responsibility to provide services to women who experience an unwanted pregnancy. They must have access to high-quality postabortion care, including family planning services. Professional midwives are ideally suited to serve as integrated reproductive health workers trained to combat the five major maternal killers: hemorrhage, sepsis, pregnancy-induced hypertension, obstructed labor, and unsafe abortion. This was demonstrated in a highly successful Life-Saving Skills for Midwives program undertaken in Ghana, Nigeria, and Uganda, and soon to start in Vietnam in conjunction with the Council's Safe Motherhood research program. Family planning services should be viewed as part of a comprehensive set of health services needed by postpartum women, which include appropriate contraception, maternal health checks, well-baby care, and information about breastfeeding, infant care, and nutrition. Family planning programs should incorporate breastfeeding counseling into their services. When

  16. Web-Based Acceptance and Commitment Therapy for Mental Health Problems in College Students: A Randomized Controlled Trial.

    Science.gov (United States)

    Levin, Michael E; Haeger, Jack A; Pierce, Benjamin G; Twohig, Michael P

    2016-07-20

    There are significant challenges in addressing the mental health needs of college students. The current study tested an acceptance and commitment therapy (ACT), web-based self-help program to treat a broad range of psychological problems students struggle with. A sample of 79 college students was randomized to web-based ACT or a waitlist condition, with assessments at baseline and posttreatment. Results indicated adequate acceptability and program engagement for the ACT website. Relative to waitlist, participants receiving ACT improved on overall distress, general anxiety, social anxiety, depression, academic concerns, and positive mental health. There were no between-group effects on eating concerns, alcohol use, or hostility, or on some key ACT process of change measures. ACT participants improved more on mindful acceptance and obstruction to valued living, both of which mediated treatment outcomes. Results are discussed in the context of lessons learned with the website prototype, and areas for further research are presented. © The Author(s) 2016.

  17. Satisfaction with a distance continuing education program for health professionals.

    Science.gov (United States)

    Bynum, Ann B; Irwin, Cathy A; Cohen, Betty

    2010-09-01

    This study assessed differences in program satisfaction among health professionals participating in a distance continuing education program by gender, ethnicity, discipline, and community size. A one-group posttest design was used with a sample of 45,996 participants in the University of Arkansas for Medical Sciences, Rural Hospital, Distance Continuing Medical Education Program during 1995-2007. This program provided 2,219 continuing education programs for physicians (n = 7,047), nurses (n = 21,264), allied health (n = 3,230) and dental (n = 305) professionals, pharmacists (n = 4,088), administrators (n = 1,211), and marketing/finance/human resources professionals (n = 343). These programs were provided in Arkansas hospitals, clinics, and area health education centers. Interactive video technology and the Internet were used to deliver these programs. The program satisfaction instrument demonstrated adequate internal consistency reliability (Cronbach's alpha = 0.91) and construct validity. Participants had high levels of satisfaction regarding knowledge and skills, use of information to enhance patient care, program quality, and convenience of the technology (mean total satisfaction score = 4.44, range: 1-5). Results from the t-test for independent samples and one-way analysis of variance indicated that men (p = 0.01), African-Americans and Hispanics (p distance continuing education programs.

  18. The Effectiveness of School-Based Nutritional Education Program among Obese Adolescents: A Randomized Controlled Study

    National Research Council Canada - National Science Library

    In-Iw, Supinya; Saetae, Tridsanun; Manaboriboon, Boonying

    2012-01-01

    ... intervention and prevention programs in order to reduce the negative health consequences in later life. Many researchers had focused on developing strategies to promote healthy eating and behavior modification at schools. The key success of school-based obesity prevention program needed the combination of cultural elements and tailored-clas...

  19. Improving Nutrition and Physical Activity Policies in Afterschool Programs: Results from a Group-Randomized Controlled Trial

    Science.gov (United States)

    Kenney, Erica L.; Giles, Catherine M.; deBlois, Madeleine E.; Gortmaker, Steven L.; Chinfatt, Sherene; Cradock, Angie L.

    2017-01-01

    OBJECTIVE Afterschool programs can be health-promoting environments for children. Written policies positively influence nutrition and physical activity (PA) environments, but effective strategies for building staff capacity to write such policies have not been evaluated. This study measures the comprehensiveness of written nutrition, PA, and screen time policies in afterschool programs and assesses impact of the Out of School Nutrition and Physical Activity (OSNAP) intervention on key policies. METHODS Twenty afterschool programs in Boston, MA participated in a group-randomized, controlled trial from September 2010 to June 2011. Intervention program staff attended learning collaboratives focused on practice and policy change. The Out-of-School Time (OST) Policy Assessment Index evaluated written policies. Inter-rater reliability and construct validity of the measure and impact of the intervention on written policies were assessed. RESULTS The measure demonstrated moderate to excellent inter-rater reliability (Spearman’s r=0.53 to 0.97) and construct validity. OSNAP was associated with significant increases in standards-based policy statements surrounding snacks (+2.6, p=0.003), beverages (+2.3, p=0.008), screen time (+0.8, p=0.046), family communication (+2.2, p=0.002), and a summary index of OSNAP goals (+3.3, p=0.02). CONCLUSIONS OSNAP demonstrated success in building staff capacity to write health-promoting policy statements. Future research should focus on determining policy change impact on practices. PMID:24941286

  20. Epigenomic programing: a future way to health?

    OpenAIRE

    Shenderov, Boris A.; Midtvedt, Tore

    2014-01-01

    It is now generally accepted that the ‘central genome dogma’ (i.e. a causal chain going from DNA to RNA to proteins and downstream to biological functions) should be replaced by the ‘fluid genome dogma’, that is, complex feed-forward and feed-back cycles that interconnect organism and environment by epigenomic programing – and reprograming – throughout life and at all levels, sometimes also down the generations. The epigenomic programing is the net sum of interactions derived from own metabol...

  1. A Qualitative Study Exploring Facilitators for Improved Health Behaviors and Health Behavior Programs: Mental Health Service Users’ Perspectives

    Directory of Open Access Journals (Sweden)

    Candida Graham

    2014-01-01

    Full Text Available Objective. Mental health service users experience high rates of cardiometabolic disorders and have a 20–25% shorter life expectancy than the general population from such disorders. Clinician-led health behavior programs have shown moderate improvements, for mental health service users, in managing aspects of cardiometabolic disorders. This study sought to potentially enhance health initiatives by exploring (1 facilitators that help mental health service users engage in better health behaviors and (2 the types of health programs mental health service users want to develop. Methods. A qualitative study utilizing focus groups was conducted with 37 mental health service users attending a psychosocial rehabilitation center, in Northern British Columbia, Canada. Results. Four major facilitator themes were identified: (1 factors of empowerment, self-value, and personal growth; (2 the need for social support; (3 pragmatic aspects of motivation and planning; and (4 access. Participants believed that engaging with programs of physical activity, nutrition, creativity, and illness support would motivate them to live more healthily. Conclusions and Implications for Practice. Being able to contribute to health behavior programs, feeling valued and able to experience personal growth are vital factors to engage mental health service users in health programs. Clinicians and health care policy makers need to account for these considerations to improve success of health improvement initiatives for this population.

  2. Group Lidcombe Program Treatment for Early Stuttering: A Randomized Controlled Trial

    Science.gov (United States)

    Arnott, Simone; Onslow, Mark; O'Brian, Sue; Packman, Ann; Jones, Mark; Block, Susan

    2014-01-01

    Purpose: This study adds to the Lidcombe Program evidence base by comparing individual and group treatment of preschoolers who stutter. Method: A randomized controlled trial of 54 preschoolers was designed to establish whether group delivery outcomes were not inferior to the individual model. The group arm used a rolling group model, in which a…

  3. The Effectiveness of Healthy Start Home Visit Program: Cluster Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2015-01-01

    Purpose: The study reported the effectiveness of a home visit program for disadvantaged Chinese parents with preschool children, using cluster randomized controlled trial design. Method: Participants included 191 parents and their children from 24 preschools, with 84 dyads (12 preschools) in the intervention group and 107 dyads (12 preschools) in…

  4. Efficacy of a Universal Parent Training Program (HOPE-20): Cluster Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Kwan, H. W.

    2017-01-01

    Objective: This study examined the efficacy of Hands-On Parent Empowerment-20 (HOPE-20) program. Methods: Eligible participants were parents residing in Hong Kong with target children aged 2 years attending nursery schools. Cluster randomized control trial was adopted, with 10 schools (110 participants) assigned to intervention group and 8 schools…

  5. Oak Park and River Forest High School Random Access Information Center; A PACE Program. Report II.

    Science.gov (United States)

    Oak Park - River Forest High School, Oak Park, IL.

    The specifications, planning, and initial development phases of the Random Access Center at the Oak Park and River Forest High School in Oak Park, Illinois, are described with particular attention to the ways that the five functional specifications and the five-part program rationale were implemented in the system design. Specifications, set out…

  6. Testing Mediators of Intervention Effects in Randomized Controlled Trials: An Evaluation of Three Depression Prevention Programs

    Science.gov (United States)

    Stice, Eric; Rohde, Paul; Seeley, John R.; Gau, Jeff M.

    2010-01-01

    Objective: Evaluate a new 5-step method for testing mediators hypothesized to account for the effects of depression prevention programs. Method: In this indicated prevention trial, at-risk teens with elevated depressive symptoms were randomized to a group cognitive-behavioral (CB) intervention, group supportive expressive intervention, CB…

  7. Using Elections as Teachable Moments: A Randomized Evaluation of the Student Voices Civic Education Program

    Science.gov (United States)

    Syvertsen, Amy K.; Stout, Michael D.; Flanagan, Constance A.

    2009-01-01

    The recommitment of public education to its civic roots has revived discussion on how to engage younger generations of citizens in electoral politics and civic life. This randomized trial of 1,670 high school students in 80 social studies classrooms evaluates the impact of an election-based civics program on students' civic knowledge, skills, and…

  8. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  9. Randomized Control Trial of a CBT Trauma Recovery Program in Palestinian Schools

    Science.gov (United States)

    Barron, Ian G.; Abdallah, Ghassan; Smith, Patrick

    2013-01-01

    The current study aimed to assess the Teaching Recovery Techniques (TRT) trauma recovery program within the context of ongoing violence. Utilizing a randomized controlled trial, 11-14-year-old students in Nablus, Palestine, were allocated by class to intervention or wait-list control conditions. Standardized measures assessed trauma exposure,…

  10. Brief report : An intervention program for parents of pediatric cancer patients: A randomized controlled trial

    NARCIS (Netherlands)

    Luteijn, EEF; Jackson, SAE; Volkmar, FR; Minderaa, RB

    1998-01-01

    Objective: To evaluate a psychoeducational intervention program for parents of pediatric cancer patients, using cognitive and behavioral techniques. Methods: Parents were randomly assigned to an intervention (n = 39) and a control condition (n = 42). Baseline assessment took place at diagnosis. Shor

  11. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  12. Programmed Physical Exertion in Recovery From Sports-Related Concussion: A Randomized Pilot Study.

    Science.gov (United States)

    Maerlender, Arthur; Rieman, Wanda; Lichtenstein, Jonathan; Condiracci, C

    2015-01-01

    Although no data exist, general practice recommends only rest following concussion. This randomized clinical trial found that programmed physical exertion during recovery produced no significant differences in recovery time between groups of participants. However, high levels of exertion were deleterious. This study provides initial evidence that moderate physical activity is a safe replacement behavior during recovery.

  13. Randomized Control Trial of a CBT Trauma Recovery Program in Palestinian Schools

    Science.gov (United States)

    Barron, Ian G.; Abdallah, Ghassan; Smith, Patrick

    2013-01-01

    The current study aimed to assess the Teaching Recovery Techniques (TRT) trauma recovery program within the context of ongoing violence. Utilizing a randomized controlled trial, 11-14-year-old students in Nablus, Palestine, were allocated by class to intervention or wait-list control conditions. Standardized measures assessed trauma exposure,…

  14. Completion report : Effect of Comprehensive Yogic Breathing program on type 2 diabetes: A randomized control trial

    Directory of Open Access Journals (Sweden)

    V P Jyotsna

    2014-01-01

    Full Text Available Background: Yoga has been shown to be benefi cial in diabetes in many studies, though randomized control trials are few. The aim of this randomized control trial was to see the effect of Sudarshan Kriya and related practices (comprehensive yogic breathing program on quality of life, glycemic control, and cardiac autonomic functions in diabetes. Diabetes mellitus is a risk factor for sudden cardiac death. Cardiac autonomic neuropathy has been implicated in the causation of sudden cardiac death. Therefore, a maneuver to prevent progression of cardiac autonomic neuropathy holds signifi cance. Materials and Methods: A total of 120 patients of diabetes on oral medication and diet and exercise advice were randomized into two groups: (1 Continued to receive standard treatment for diabetes. (2 Patients administered comprehensive yogic breathing program and monitored to regularly practice yoga in addition to standard treatment of diabetes. At 6 months, quality of life and postprandial plasma glucose signifi cantly improved in the group practicing yoga compared to baseline, but there was no significant improvement in the fasting plasma glucose and glycated hemoglobin. Results: On per protocol analysis, sympathetic cardiac autonomic functions signifi cantly improved from baseline in the group practicing comprehensive yogic breathing. Conclusion: This randomized control trial points towards the beneficial effect of yogic breathing program in preventing progression of cardiac neuropathy. This has important implications as cardiac autonomic neuropathy has been considered as one of the factors for sudden cardiac deaths.Keywords: comprehensive yogic breathing program, diabetes mellitus, cardiac autonomic function

  15. 76 FR 16422 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2011-03-23

    ... Health Insurance Programs; Provider Enrollment Application Fee Amount for 2011 AGENCY: Centers for... with comment period entitled: ``Medicare, Medicaid, and Children's Health Insurance Programs... Health Insurance Program (CHIP) provider enrollment processes. Specifically, and as stated in 42 CFR 424...

  16. 77 FR 71423 - Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee...

    Science.gov (United States)

    2012-11-30

    ... or Medicaid program or the Children's Health Insurance Program (CHIP); revalidating their Medicare... Health Insurance Programs; Additional Screening Requirements, Application Fees, Temporary Enrollment... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND...

  17. 78 FR 9457 - Medicare, Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of...

    Science.gov (United States)

    2013-02-08

    ... 42 CFR Parts 402 and 403 Medicare, Medicaid, Children's Health Insurance Programs; Transparency..., Medicaid, Children's Health Insurance Programs; Transparency Reports and Reporting of Physician Ownership... medical supplies covered by Medicare, Medicaid or the Children's Health Insurance Program (CHIP) to report...

  18. Random-access technique for modular bathymetry data storage in a continental shelf wave refraction program

    Science.gov (United States)

    Poole, L. R.

    1974-01-01

    A study was conducted of an alternate method for storage and use of bathymetry data in the Langley Research Center and Virginia Institute of Marine Science mid-Atlantic continental-shelf wave-refraction computer program. The regional bathymetry array was divided into 105 indexed modules which can be read individually into memory in a nonsequential manner from a peripheral file using special random-access subroutines. In running a sample refraction case, a 75-percent decrease in program field length was achieved by using the random-access storage method in comparison with the conventional method of total regional array storage. This field-length decrease was accompanied by a comparative 5-percent increase in central processing time and a 477-percent increase in the number of operating-system calls. A comparative Langley Research Center computer system cost savings of 68 percent was achieved by using the random-access storage method.

  19. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    Science.gov (United States)

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  20. Counseling Health Psychology: Assessing Health Psychology Training within Counseling Psychology Doctoral Programs

    Science.gov (United States)

    Raque-Bogdan, Trisha L.; Torrey, Carrie L.; Lewis, Brian L.; Borges, Nicole J.

    2013-01-01

    Training directors of American Psychological Association-approved counseling psychology doctoral programs completed a questionnaire assessing (a) student and faculty involvement in health-related research, practice, and teaching; (b) health-related research conducted by students and faculty; and (c) programs' expectations and ability to…

  1. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  2. Health Occupations Education Program Development Guide No. 5: Dental Assisting.

    Science.gov (United States)

    New York State Education Dept., Albany. Div. of Occupational Education Instruction.

    The bulletin, which is part of the New York State "Health Occupations Education Program Development Guide Series," focuses on the dental assisting program. The curriculum is designed to provide training for dental assistants in their assistant role at chairside, in the dental operatory and laboratory, and in the dental office and reception area. A…

  3. Outcomes Assessment in Accredited Health Information Management Programs

    Science.gov (United States)

    Bennett, Dorine

    2010-01-01

    The purpose of this study was to determine the use and perceived usefulness of outcomes assessment methods in health information management programs. Additional characteristics of the outcomes assessment practices were recognized. The findings were evaluated for significant differences in results based on age of the program, type of institution,…

  4. Mindfulness Training for Health Profession Students-The Effect of Mindfulness Training on Psychological Well-Being, Learning and Clinical Performance of Health Professional Students: A Systematic Review of Randomized and Non-randomized Controlled Trials.

    Science.gov (United States)

    McConville, Janet; McAleer, Rachael; Hahne, Andrew

    High levels of stress have been identified in medical students and increasingly in other health profession student population groups. As stress can affect psychological well-being and interfere with learning and clinical performance, there is a clear argument for universities to include health professional student well-being as an outcome in core curriculum. Mindfulness training is a potential construct to manage stress and enhance academic success. The aims of this systematic review were to assess the effectiveness of mindfulness training in medical and other health professional student population groups and to compare the effectiveness of the different mindfulness-based programs. A literature search was completed using The Cochrane library, Medline, Cinahl, Embase, Psychinfo, and ERIC (proquest) electronic databases from inception to June 2016. Randomized and non-randomized controlled trials were included. Of the potential 5355 articles, 19 met the inclusion criteria. Studies focused on medical (n = 10), nursing (n = 4), social work (n = 1), psychology (n = 1), and medical plus other health (n = 3) students. Interventions were based on mindfulness. The 19 studies included 1815 participants. Meta-analysis was performed evaluating the effect of mindfulness training on mindfulness, anxiety, depression, stress, mood, self-efficacy, and empathy. The effect of mindfulness on academic performance was discussed. Mindfulness-based interventions decrease stress, anxiety, and depression and improve mindfulness, mood, self-efficacy, and empathy in health profession students. Due to the range of presentation options, mindfulness training can be relatively easily adapted and integrated into health professional training programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Worksite health promotion programs with environmental changes a systematic review

    NARCIS (Netherlands)

    Engbers, L.H.; Poppel, van M.N.M.; Chin A Paw, M.J.M.; Mechelen, van W.

    2005-01-01

    BACKGROUND: It is now widely believed that health promotion strategies should go beyond education or communication to achieve significant behavioral changes among the target population. Environmental modifications are thought to be an important addition to a worksite health promotion program (WHPP).

  6. Risky business: effectiveness of state market-based health programs.

    Science.gov (United States)

    Stream, Christopher; Myers, Nathan

    2010-02-01

    Since the 1990s, state governments have been leaders of health care reform. Today, approximately 47 million people are without health insurance. As health care costs and uninsurance levels continue to rise, states are pursuing a variety of government- and market-based strategies to address this growing social problem. Health care research has indicated that state-based programs have proven to be successful in extending access to coverage. However, the question remains as to whether the market-based programs have had a positive impact on state health care. Advocates for market-based state health programs argue that the reforms benefit the greater good because they serve an economic development function by improving the economic productivity and overall health of state citizens. Whether market-based policies are accomplishing these goals is a matter of debate. This study examines the effects of the various market-based state policies. The evidence generated by this research sheds light on the societal effectiveness of market-based health care strategies used by state governments. The results of our analysis indicate that programs enacted by states to promote increased access to medical care have developmental effects beyond the client population directly served.

  7. Connecting the Dots: How U.S. Global Health Programs Can Improve International Health Regulation Compliance

    Science.gov (United States)

    2014-12-01

    health initiative (GHI) that seeks to improve specific health principles such as expanding disease treatment and improving maternal child health.27...of smallpox by the 1980s demonstrated the efficacy of global health measures and served as an example for other disease vaccination programs.82 In...files/documents/1864/USAID_50-Years- of-Global-Health.pdf. 82 Ibid., 23. 83 Ibid., 26—7. 84 Ibid., 59. 20 Child Survival Initiative, the Polio

  8. School-based teenage pregnancy prevention programs: a systematic review of randomized controlled trials.

    Science.gov (United States)

    Bennett, Sylvana E; Assefi, Nassim P

    2005-01-01

    We compared school-based abstinence-only programs with those including contraceptive information (abstinence-plus) to determine which has the greatest impact on teen pregnancy. The United States has one of the highest rates of teen pregnancy in the industrialized world. Programs aimed at reducing the rate of teen pregnancy include a myriad of approaches including encouraging abstinence, providing education about birth control, promoting community service activities, and teaching skills to cope with peer pressure. We systematically reviewed all published randomized controlled trials of secondary-school-based teen pregnancy prevention programs in the United States that used sexual behavior, contraceptive knowledge, contraceptive use, and pregnancy rates as outcomes.

  9. Implementation of Health Fitness Exercise Programs.

    Science.gov (United States)

    Cundiff, David E., Ed.

    This monograph includes the following articles to aid in implementation of fitness concepts: (1) "Trends in Physical Fitness: A Personal Perspective" (H. Harrison Clarke); (2) "A Total Health-Fitness Life-Style" (Steven N. Blair); (3) "Objectives for the Nation--Physical Fitness and Exercise" (Jack H. Wilmore); (4) "A New Physical Fitness Test"…

  10. Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-01-01

    In this report unified ideas are presented about what the Office of International Health Programs does, what the individual contributions are, and how the organization connects to the Department of Energy. The planning efforts have focused on the office`s three areas of responsibility: Europe, Japan, and the Marshall Islands. Common to each technical program area are issues related to the following: health of populations exposed to radiation incidents and the associated medical aspects of exposure; dose reconstruction; training; and public involvement. Each of the program areas, its customers, and primary customer interests are described.

  11. Implementing intelligent physical exercise training at the workplace: health effects among office workers—a randomized controlled trial

    DEFF Research Database (Denmark)

    Dalager, Tina; Justesen, Just Bendix; Murray, Mike;

    2016-01-01

    Purpose: The aim was to assess 1-year cardiovascular health effects of Intelligent Physical Exercise Training, IPET. Methods: Office workers from six companies were randomized 1:1 to a training group, TG (N = 194) or a control group, CG (N = 195). TG received 1-h supervised high intensity IPET...... every week within working hours for 1 year, and was recommended to perform 30-min of moderate intensity physical activity 6 days a week during leisure. The training program was based on baseline health check measures of cardiorespiratory fitness (CRF), body composition, blood pressure, blood profile....... Conclusion: High intensity IPET combined with the recommendations of moderate intensity physical activity demonstrated significant clinical relevant improvements in CRF and systolic blood pressure. This underlines the effectiveness of health promotion by implementing physical exercise training...

  12. Exercise program for prevention of groin pain in football players: a cluster-randomized trial

    DEFF Research Database (Denmark)

    Hölmich, P; Larsen, K; Krogsgaard, Kim

    2010-01-01

    Groin injuries cause major problems in sports and particularly in football. Exercise is effective in treating adductor-related groin pain, but no trials have been published regarding the specific prevention of groin pain or prevention specifically targeting overuse injuries in sport using exercise...... programs. We performed a cluster-randomized trial including 55 football clubs representing 1211 players. The clubs were randomized to an exercise program aimed at preventing groin injuries (n=27) or to a control group training as usual (n=28). The intervention program consisted of six exercises including...... strengthening (concentric and eccentric), coordination, and core stability exercises for the muscles related to the pelvis. Physiotherapists assigned to each club registered all groin injuries. Twenty-two clubs in each group completed the study, represented by 977 players. There was no significant effect...

  13. Supportive supervision for volunteers to deliver reproductive health education: a cluster randomized trial.

    Science.gov (United States)

    Singh, Debra; Negin, Joel; Orach, Christopher Garimoi; Cumming, Robert

    2016-10-03

    Community Health Volunteers (CHVs) can be effective in improving pregnancy and newborn outcomes through community education. Inadequate supervision of CHVs, whether due to poor planning, irregular visits, or ineffective supervisory methods, is, however, recognized as a weakness in many programs. There has been little research on best practice supervisory or accompaniment models. From March 2014 to February 2015 a proof of concept study was conducted to compare training alone versus training and supportive supervision by paid CHWs (n = 4) on the effectiveness of CHVs (n = 82) to deliver education about pregnancy, newborn care, family planning and hygiene. The pair-matched cluster randomized trial was conducted in eight villages (four intervention and four control) in Budondo sub-county in Jinja, Uganda. Increases in desired behaviors were seen in both the intervention and control arms over the study period. Both arms showed high retention rates of CHVs (95 %). At 1 year follow-up there was a significantly higher prevalence of installed and functioning tippy taps for hand washing (p reproductive health care by addressing cultural norms and scientific misconceptions. Having a team of 2 CHWs to 40 CHVs enables close to community access to information, conversation and services. Supportive supervision involves creating a non-threatening, empowering environment in which both the CHV and the supervising CHW learn together and overcome obstacles that might otherwise demotivate the CHV. While the results seem promising for added value with supportive supervision for CHVs undertaking reproductive health activities, further research on a larger scale will be needed to substantiate the effect.

  14. 76 FR 5861 - Medicare, Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements...

    Science.gov (United States)

    2011-02-02

    ..., and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees..., Medicaid, and Children's Health Insurance Programs; Additional Screening Requirements, Application Fees... reauthorized Indian Health Care Improvement Act, `` ny requirement for participation as a provider of health...

  15. Certification programs for eHealth--status quo.

    Science.gov (United States)

    Urbauer, Philipp; Herzog, Juliane; Pohn, Birgit; Forjan, Mathias; Sauermann, Stefan

    2014-01-01

    The skills of the workforce are a core factor for the quality of healthcare systems. On top of the basic education, postgraduate training is an important factor for continuously maintaining as well as improving the workforce qualification level. Advanced training often provides certification of the acquired skills. This paper analyses the status quo of international certification programs in the sector of eHealth (EU, US, Global). It uses available literature and observations from international educational expert's workgroups. It identifies gaps regarding certifications in eHealth and suggests steps for solutions. Despite little attention to legal and financial eHealth related content in certification programs in the EU as well as a low degree of harmonization of international certifications in general, there are strong activities especially in the international scope towards personal certification programs in eHealth. Major changes are to be expected within the coming years.

  16. Design and baseline findings of a multi-site non-randomized evaluation of the effect of a health programme on microfinance clients in India.

    Science.gov (United States)

    Saha, Somen

    2013-10-12

    Microfinance is the provision of financial services for the poor. Health program through microfinance has the potential to address several access barriers to health. We report the design and baseline findings of a multi-site non-randomized evaluation of the effect of a health program on the members of two microfinance organizations from Karnataka and Gujarat states of India. Villages identified for roll-out of health services with microfinance were pair-matched with microfinance only villages. A quantitative survey at inception and twelve months post health intervention compare the primary outcome (incidence of childhood diarrhea), and secondary outcome (place of last delivery, toilet at home, and out-of-pocket expenditure on treatment). At baseline, the intervention and comparison communities were similar except for out-of-pocket expenditure on health. Low reported use of toilet at home indicates the areas are heading towards a sanitation crisis. This should be an area of program priority for the microfinance organizations. While respondents primarily rely on their savings for meeting treatment expenditure, borrowing from friends, relatives, and money-lenders remains other important source of meeting treatment expenditure in the community. Programs need to prioritize steps to ensure awareness about national health insurance schemes, entitlement to increase service utilization, and developing additional health financing safety nets for financing outpatient care, that are responsible for majority of health-debt. Finally we discuss implications of such programs for national policy makers.

  17. Improving Defense Health Program Medical Research Processes

    Science.gov (United States)

    2017-08-08

    Health (NIH), Centers for Disease Control and Prevention , private foundations, and others (Figure 1b). These disparate funding sources may fund...Reed and his team’s discovery and confirmation of the transmission of deadly diseases such as typhoid fever and yellow fever. 5 Researchers also...contributed to the development of intravenous therapy for cholera ; 6 and the development of anti- malarial agents such as chloroquine, doxycycline

  18. Future Recommendations for School Dental Health Program in India

    Directory of Open Access Journals (Sweden)

    Thorakkal SHAMIM

    2015-10-01

    Full Text Available Dental Surgeons working in public sector have an important role to play in school dental health pro-gram to reinstitute the oral and dental health of growing population of India. Even though the oral health policy was drafted in India in 1995, it was not implemented till this date (1. It is im-portant to enhance the knowledge about good oral health in teachers and parents by caring out workshops and seminars on oral and dental health by dental Surgeons working in public health sector. Dental surgeons working in public health sector should carry out oral screening to improve the future of oral health care in India (2. Mobile den-tal unit is an effective method to render oral and dental health-care in the public sector and it should be implemented in school set up in multi-ple situations such as educating school children regarding oral and dental health, screening of school children for various oral diseases, school and community dental health program(3.In an interventional study conducted among rural school children in Nalgonda district to assess the oral health promotion, it was interfered that the School teachers may be utilized as good medium for oral health promotion among school children in India and other developing countries(4.The following recommendations should be incor-porated in school health program in India. The government should incorporate dental surgeons in school health programs to give lecture on oral health, oral hygiene, plaque control, oral and den-tal diseases, oral cancer or smokeless tobacco use and hazards counseling and topical fluoride appli-cation. The government should incorporate oral and dental health related topic in School curric-ulum. Compulsory fitness regarding oral and den-tal health should be made mandatory for class promotion. Dental Surgeons play an important role in recognizing child abuse in school set up (5. Dentists should evaluate child abuse cases and child abuse cases will present clinically as

  19. 78 FR 6275 - Medicaid, Children's Health Insurance Programs, and Exchanges: Essential Health Benefits in...

    Science.gov (United States)

    2013-01-30

    ... 457 Office of the Secretary 45 CFR Part 155 RIN 0938-AR04 Medicaid, Children's Health Insurance... Federal Register entitled ``Medicaid, Children's Health Insurance Programs, and Exchanges: Essential... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND...

  20. Health Matters for People with Developmental Disabilities: Creating a Sustainable Health Promotion Program

    Science.gov (United States)

    Marks, Beth; Sisirak, Jasmina; Heller, Tamar

    2010-01-01

    Adults with developmental disabilities are at significant risk for health problems. Effective health promotion can improve outcomes--and that's why adult day and residential agencies, schools, and other organizations need this invaluable program development guide. An urgent call to action and a start-to-finish framework for health promotion, this…

  1. Health Matters for People with Developmental Disabilities: Creating a Sustainable Health Promotion Program

    Science.gov (United States)

    Marks, Beth; Sisirak, Jasmina; Heller, Tamar

    2010-01-01

    Adults with developmental disabilities are at significant risk for health problems. Effective health promotion can improve outcomes--and that's why adult day and residential agencies, schools, and other organizations need this invaluable program development guide. An urgent call to action and a start-to-finish framework for health promotion, this…

  2. Including oral health training in a health system strengthening program in Rwanda

    Directory of Open Access Journals (Sweden)

    Brittany Seymour

    2013-03-01

    Full Text Available Objective: Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. Design: In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined ‘vertical’ direct patient care training with ‘horizontal’ interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. Results: The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Conclusions: Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

  3. Including oral health training in a health system strengthening program in Rwanda.

    Science.gov (United States)

    Seymour, Brittany; Muhumuza, Ibra; Mumena, Chris; Isyagi, Moses; Barrow, Jane; Meeks, Valli

    2013-03-08

    Rwanda's Ministry of Health, with the Clinton Health Access Initiative, implemented the Human Resources for Health (HRH) Program. The purpose of the program is to train and retain high-quality health care professionals to improve and sustain health in Rwanda. In May 2011, an oral health team from Rwanda and the United States proposed that oral health be included in the HRH Program, due to its important links to health, in a recommendation to the Rwandan Ministry of Health. The proposal outlined a diagonal approach to curriculum design that supports the principles of global health through interconnected training for both treatment and collaborative prevention, rather than discipline-based fragmented training focused on isolated risk factors. It combined 'vertical' direct patient care training with 'horizontal' interdisciplinary training to address common underlying risk factors and associations for disease through primary care, program retention, and sustainability. The proposal was accepted by the Ministry of Health and was approved for funding by the US Government and The Global Fund. Rwanda's first Bachelor of Dental Surgery program, which is in the planning phase, is being developed. Competencies, the training curriculum, insurance and payment schemes, licensure, and other challenges are currently being addressed. With the Ministry of Health supporting the dental HRH efforts and fully appreciating the importance of oral health, all are hopeful that these developments will ultimately lead to more robust oral health data collection, a well-trained and well-retained dental profession, and vastly improved oral health and overall health for the people of Rwanda in the decades to come.

  4. The NASA-USPHS Health Evaluation and Enhancement Program

    Science.gov (United States)

    Durbeck, D. C.; Heinzelmann, F.; Moxley, R. T., III; Schacther, J.; Payne, G. H.; Limoncelli, D. D.; Fox, S. M., III; Arnoldi, L. B.

    1972-01-01

    An exercise program was initiated to assess the feasibility of an on the job health evaluation and enhancement program, as well as to identify the factors which influenced volunteering, adherence, and effectiveness of the program. The program was utilized by 237 of the 998 eligible Federal employees, with a mean attendance of 1.3 days per week. Those who volunteered perceived a need for increased physical activity, felt they had sufficient time to participate, and derived subjective as well as objective benefits. Significant improvements were found in heart rate response to the standard exercise test, body weight, skinfold measurements, and triglycerides. A consistent relationship was found between subjectively reported effects of the program on work, health habits, and behavior, and improvement in cardiovascular function, based on treadmill performance. Numerous personal and programmatic factors influencing volunteering and participation were identified.

  5. Factors influencing perceived sustainability of Dutch community health programs.

    Science.gov (United States)

    Vermeer, A J M; Van Assema, P; Hesdahl, B; Harting, J; De Vries, N K

    2015-09-01

    We assessed the perceived sustainability of community health programs organized by local intersectoral coalitions, as well as the factors that collaborating partners think might influence sustainability. Semi-structured interviews were conducted among 31 collaborating partners of 5 community health programs in deprived neighborhoods in the southern part of the Netherlands. The interview guide was based on a conceptual framework that includes factors related to the context, the leading organization, leadership, the coalition, collaborating partners, interventions and outcomes. Interviews were recorded, transcribed and content analyzed using NVivo 8.0. Participants in each of the programs varied in their perceptions of the sustainability of the program, but those people collaborating in pre-existing neighborhood structures expressed relatively high faith in their continuation. The participating citizens in particular believed that these structures would continue to address the health of the community in the future. We found factors from all categories of the conceptual framework that were perceived to influence sustainability. The program leaders appeared to be crucial to the programs, as they were frequently mentioned in close interaction with other factors. Program leaders should use a motivating and supportive leadership style and should act as 'program champions'. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. The Effect of Health Belief Model-Based Education on Knowledge and Prostate Cancer Screening Behaviors: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Maryam Zare

    2016-01-01

    Full Text Available Background: Prostate cancer has been reported as the second leading cause of cancer death among men in 2013. Prevention and early detection of cancer are considered as critical factors in controlling the disease and increasing the survival of patients. Therefore, we aimed to investigate the effect of Health Belief Model (HBM-based education onknowledge and prostate cancer screening behaviors in a randomized controlled trial. Methods: This study was a non-blinded randomized controlled trial. We enrolled 210 men aged 50-70. Balanced block randomization method was used to randomize the final participants who had inclusion criteria into intervention (n=93 and control (n=87 groups. The participants of the intervention group attended training workshops based on HBM. Data were collected using three questionnaires, i.e. demographic questionnaire, Prostate Cancer Screening-Health Belief Model Scale (PCS-HBMS, and the Knowledge about Prostate Cancer Screening questionnaire, all given before and immediately one month after the intervention. Results: The mean scores of the perceived susceptibility, severity, barriers and benefits increased significantly after the intervention (P>0.05 in the intervention group. In the control group, such a difference was reported only for perceived susceptibility (P>0.05. The rate of participation in prostate cancer screening in the intervention group increased from 7.5% to 24% and 43.3% one month and three months after the intervention, respectively. Conclusion: Our findings showed that the health education programs designed based on HBM could positively affect prostate cancer preventive behaviors of individuals by improving their knowledge level and leaving positive effects on perceived susceptibility and severity as well as considering the perceived barriers, benefits and health motivations.

  7. The APRU Global Health Program: Past and Future

    Directory of Open Access Journals (Sweden)

    Jonathan Samet

    2016-04-01

    Full Text Available The Association of Pacific Rim Universities (APRU is an international consortium of 45 universities in the Pacific Rim, representing 16 economies, 130 000 faculty members and more than two million students. The APRU Global Health Program aims to expand existing collaborative research efforts among universities to address regional and global health issues. Since its launch in 2007–08, the program has covered a significant range of topics including emerging public health threats, ageing and chronic diseases, infectious diseases and health security issues, among others. The Program’s activities in research, training, and service around the globe illustrate the diverse dimensions of global health. In this paper, the major activities to date are outlined and future planned activities are discussed.

  8. Thoughts About Health Policy Content in Baccalaureate Nursing Programs.

    Science.gov (United States)

    Waddell, Ashley; Adams, Jeffrey M; Fawcett, Jacqueline

    2016-10-01

    We describe a framework used to analyze health policy content in baccalaureate nursing program courses that combines the conceptual model for nursing and health policy and the Adams influence model to account for knowledge and skills needed for health policy work. Our analysis of health policy content in courses in one baccalaureate nursing program focused on what policies were emphasized and how educational content supported the development of personal influence. The analysis revealed course content focused on public sources of health policies and lack of overt course content about policies from organizational and professional sources. Additionally, we identified little course content about the development of personal influence skills except for communication and message articulation components. As the nursing profession continues to build influence in the policy arena, educators must continue to prepare future nurses for such work. © The Author(s) 2016.

  9. Outcomes from consumer-operated and community mental health services: a randomized controlled trial.

    Science.gov (United States)

    Segal, Steven P; Silverman, Carol J; Temkin, Tanya L

    2011-08-01

    Hierarchically organized board-and-staff-run consumer-operated service programs (COSPs) are viewed as organizations that promote recovery while working in concert with community mental health agencies (CMHAs). This study's objective was to determine the effectiveness of such combined services for people with serious mental illness. A board-and-staff-run consumer-operated drop-in center and colocated CMHA provided the context for the randomized clinical trial. In a weighted sample, 139 new clients seeking help from the CMHA were randomly assigned to agency-only service or to a combination of COSP and CMHA services. Client-members were assessed at baseline and eight months on a measure of symptom severity and on four recovery-focused outcome measures: personal empowerment, self-efficacy, independent social integration, and hopelessness. All scales used have high reliability and well-established validity. Differences in outcome by service condition were evaluated with multivariate analysis of covariance via dummy variable regression. Change scores on the five outcomes were the dependent variables. The covariates for the multivariate analysis included baseline status on each outcome measure and service condition between-group demographic differences. Results indicated that significant changes in three recovery-focused outcomes were associated with service condition across time: social integration (pempowerment (p<.006), and self-efficacy (p<.001). All changes favored the CMHA-only condition. Neither symptomology nor hopelessness differed by service condition across time. Hierarchically organized board-and-staff-run COSPs combined with CMHA service may be less helpful than CMHA service alone.

  10. Assessing environmental assets for health promotion program planning: a practical framework for health promotion practitioners.

    Science.gov (United States)

    Springer, Andrew E; Evans, Alexandra E

    2016-01-01

    Conducting a health needs assessment is an important if not essential first step for health promotion planning. This paper explores how health needs assessments may be further strengthened for health promotion planning via an assessment of environmental assets rooted in the multiple environments (policy, information, social and physical environments) that shape health and behavior. Guided by a behavioral-ecological perspective- one that seeks to identify environmental assets that can influence health behavior, and an implementation science perspective- one that seeks to interweave health promotion strategies into existing environmental assets, we present a basic framework for assessing environmental assets and review examples from the literature to illustrate the incorporation of environmental assets into health program design. Health promotion practitioners and researchers implicitly identify and apply environmental assets in the design and implementation of health promotion interventions;this paper provides foundation for greater intentionality in assessing environmental assets for health promotion planning.

  11. Multiobjective Two-Stage Stochastic Programming Problems with Interval Discrete Random Variables

    Directory of Open Access Journals (Sweden)

    S. K. Barik

    2012-01-01

    Full Text Available Most of the real-life decision-making problems have more than one conflicting and incommensurable objective functions. In this paper, we present a multiobjective two-stage stochastic linear programming problem considering some parameters of the linear constraints as interval type discrete random variables with known probability distribution. Randomness of the discrete intervals are considered for the model parameters. Further, the concepts of best optimum and worst optimum solution are analyzed in two-stage stochastic programming. To solve the stated problem, first we remove the randomness of the problem and formulate an equivalent deterministic linear programming model with multiobjective interval coefficients. Then the deterministic multiobjective model is solved using weighting method, where we apply the solution procedure of interval linear programming technique. We obtain the upper and lower bound of the objective function as the best and the worst value, respectively. It highlights the possible risk involved in the decision-making tool. A numerical example is presented to demonstrate the proposed solution procedure.

  12. RAP: a computer program for exploring similarities in behavior sequences using random projections.

    Science.gov (United States)

    Quera, Vicenç

    2008-02-01

    A computer program (RAP, for random projection) for exploring similarities between and within sequences of behavior is presented. Given a time window of a sequence, the program calculates a signature, a real-valued vector that is a random projection of the contents of the window (i.e., the codes occurring within it and their relative location, or onset and offset times) into an arbitrary K-dimensional space. Then, given two different time windows from the same sequence or from different sequences, their similarity is computed as an inverse function of the Euclidean distance between their respective signatures. By defining moving (overlapped or not overlapped) windows along each sequence and calculating similarities between every pair of windows from the two sequences, a map of similarities or possible recurrent patterns is obtained; the RAP program represents them as gray-level lattices, which are displayed as mouse-sensitive images in an HTML file. Computation of similarities is based on the random projection method, as presented by Mannila and Seppänen (2001), for the analysis of sequences of events. The program reads sequence data files in Sequential Data Interchange Standard (SDIS) format (Bakeman Quera, 1992,1995a).

  13. Creating Healthful Home Food Environments: Results of a Study with Participants in the Expanded Food and Nutrition Education Program

    Science.gov (United States)

    Cullen, Karen Weber; Smalling, Agueda Lara; Thompson, Debbe; Watson, Kathleen B.; Reed, Debra; Konzelmann, Karen

    2009-01-01

    Objective: To evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention. Design: Two-group randomized control trial; intervention versus usual EFNEP curriculum. Setting: Texas EFNEP classes. Participants:…

  14. Measuring the diffusion of innovative health promotion programs.

    Science.gov (United States)

    Steckler, A; Goodman, R M; McLeroy, K R; Davis, S; Koch, G

    1992-01-01

    Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.

  15. Components of cultural competence in three mental health programs.

    Science.gov (United States)

    Siegel, Carole; Haugland, Gary; Reid-Rose, Lenora; Hopper, Kim

    2011-06-01

    The aim of this study was to identify components of cultural competence in mental health programs developed for cultural groups by community and mental health professionals from these groups. Three programs were studied: a prevention program primarily serving African-American and Afro-Caribbean youth, a Latino adult acute inpatient unit, and a Chinese day treatment program in a community-based agency. Nine study-trained field researchers used a semistructured instrument that captures program genealogy, structure, processes, and cultural infusion. Program cultural elements were identified from field notes and from individual and group interviews of consumers and staff (N=104). A research-group consensus process with feedback from program staff was used to group elements by shared characteristics into the program components of cultural competence. Components included communication competencies (with use of colloquialisms and accepted forms of address); staff in culturally acceptable roles; culturally framed trust building (such as pairing youths with mentors), stigma reduction, friendly milieus (such as serving culturally familiar foods and playing music popular with the culture), and services; and peer, family, and community involvement (including use of peer counselors and mentors, hosting parent weekends, and linking clients with senior center and community services). Incorporating these components into any program in which underserved cultural populations are seen is recommended for improving cultural competence.

  16. Global Health Education in US Pediatric Residency Programs.

    Science.gov (United States)

    Butteris, Sabrina M; Schubert, Charles J; Batra, Maneesh; Coller, Ryan J; Garfunkel, Lynn C; Monticalvo, David; Moore, Molly; Arora, Gitanjli; Moore, Melissa A; Condurache, Tania; Sweet, Leigh R; Hoyos, Catalina; Suchdev, Parminder S

    2015-09-01

    Despite the growing importance of global health (GH) training for pediatric residents, few mechanisms have cataloged GH educational opportunities offered by US pediatric residency programs. We sought to characterize GH education opportunities across pediatric residency programs and identify program characteristics associated with key GH education elements. Data on program and GH training characteristics were sought from program directors or their delegates of all US pediatric residency programs during 2013 to 2014. These data were used to compare programs with and without a GH track as well as across small, medium, and large programs. Program characteristics associated with the presence of key educational elements were identified by using bivariate logistic regression. Data were collected from 198 of 199 active US pediatric residency programs (99.5%). Seven percent of pediatric trainees went abroad during 2013 to 2014. Forty-nine programs (24.7%) reported having a GH track, 66.1% had a faculty lead, 58.1% offered international field experiences, and 48.5% offered domestic field experiences. Forty-two percent of programs reported international partnerships across 153 countries. Larger programs, those with lead faculty, GH tracks, or partnerships had significantly increased odds of having each GH educational element, including pretravel preparation. The number of pediatric residency programs offering GH training opportunities continues to rise. However, smaller programs and those without tracks, lead faculty, or formal partnerships lag behind with organized GH curricula. As GH becomes an integral component of pediatric training, a heightened commitment is needed to ensure consistency of training experiences that encompass best practices in all programs. Copyright © 2015 by the American Academy of Pediatrics.

  17. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    Science.gov (United States)

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  18. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    Directory of Open Access Journals (Sweden)

    Markiewicz Milissa

    2012-02-01

    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  19. Virtual Behavioral Health Program at TAMC

    Science.gov (United States)

    2011-01-25

    Guam  Services to National Guard/Army Reserve Families and Soldiers living on the Hawaiian Islands and remote islands of the Pacific  Services to...Assessment Program 2011 MHS Conference Mahalo! 27 raymond.folen@us.army.mil suzie.martin@us.army.mil brenda.edmonds@us.army.mil Tue 80°F | 69°F Wed 80°F...70°F Thur 78°F | 69°F Fri 78°F | 68°F Weather for Honolulu, HI Tue 50°F | 35°F Wed 41°F | 34°F Thu 39°F | 27°F Fri 39°F | 30°F Weather for Washington, DC

  20. Poverty, safety net programs, and African Americans' mental health.

    Science.gov (United States)

    Snowden, Lonnie R

    2014-11-01

    African Americans' poverty and deep-poverty rates are higher than those of Whites, and African Americans' poverty spells last longer. Furthermore, nonpoor African Americans are especially likely to slip into poverty, and over the course of a lifetime, very many African Americans will experience poverty. Accordingly, African Americans are disproportionately likely to be assisted by safety net programs providing income support and health and social assistance. When mental health-related outcomes are assessed, U.S.-focused and international studies of safety net programs sometimes find that adults and children show a decline in symptoms of mental illness after participating. All things being equal, these improvements can disproportionately benefit African Americans' mental health. Safety net programs' mental health-related impact should be routinely assessed when evaluating the programs' economic and social outcomes and the impact they have on African Americans' mental health. Policy research of this kind can help us to understand whether these very large interventions show society-wide mental health-related improvement in the disproportionately large number of African Americans who participate in them.

  1. Evaluation of cluster-randomized trials on maternal and child health research in developing countries

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Chakraborty, Hrishikesh; Sen, Pranab Kumar

    2009-01-01

    To summarize and evaluate all publications including cluster-randomized trials used for maternal and child health research in developing countries during the last 10 years. METHODS: All cluster-randomized trials published between 1998 and 2008 were reviewed, and those that met our criteria...... for inclusion were evaluated further. The criteria for inclusion were that the trial should have been conducted in maternal and child health care in a developing country and that the conclusions should have been made on an individual level. Methods of accounting for clustering in design and analysis were......, and the trials generally improved in quality. CONCLUSIONS: Shortcomings exist in the sample-size calculations and in the analysis of cluster-randomized trials conducted during maternal and child health research in developing countries. Even though there has been improvement over time, further progress in the way...

  2. Evaluation of cluster-randomized trials on maternal and child health research in developing countries

    DEFF Research Database (Denmark)

    Handlos, Line Neerup; Chakraborty, Hrishikesh; Sen, Pranab Kumar

    2009-01-01

    To summarize and evaluate all publications including cluster-randomized trials used for maternal and child health research in developing countries during the last 10 years. METHODS: All cluster-randomized trials published between 1998 and 2008 were reviewed, and those that met our criteria...... for inclusion were evaluated further. The criteria for inclusion were that the trial should have been conducted in maternal and child health care in a developing country and that the conclusions should have been made on an individual level. Methods of accounting for clustering in design and analysis were......, and the trials generally improved in quality. CONCLUSIONS: Shortcomings exist in the sample-size calculations and in the analysis of cluster-randomized trials conducted during maternal and child health research in developing countries. Even though there has been improvement over time, further progress in the way...

  3. Global agenda, local health: including concepts of health security in preparedness programs at the jurisdictional level.

    Science.gov (United States)

    Eby, Chas

    2014-01-01

    The Global Health Security Agenda's objectives contain components that could help health departments address emerging public health challenges that threaten the population. As part of the agenda, partner countries with advanced public health systems will support the development of infrastructure in stakeholder health departments. To facilitate this process and augment local programs, state and local health departments may want to include concepts of health security in their public health preparedness offices in order to simultaneously build capacity. Health security programs developed by public health departments should complete projects that are closely aligned with the objectives outlined in the global agenda and that facilitate the completion of current preparedness grant requirements. This article identifies objectives and proposes tactical local projects that run parallel to the 9 primary objectives of the Global Health Security Agenda. Executing concurrent projects at the international and local levels in preparedness offices will accelerate the completion of these objectives and help prevent disease epidemics, detect health threats, and respond to public health emergencies. Additionally, future funding tied or related to health security may become more accessible to state and local health departments that have achieved these objectives.

  4. Evaluations of organizational effectiveness in mental health programs.

    Science.gov (United States)

    Scheid, T L; Greenley, J R

    1997-12-01

    We present a conceptual framework derived from organizational theory for understanding the evaluation of the effectiveness of mental health services. We postulate that organizations are deemed "successful" by their constituents when they conform to institutional demands and expectations that are both internally and externally generated. We empirically assess institutional conformity by examining evaluations of effectiveness by 269 mental health providers in 29 different mental health programs. Specialist programs responded to institutional demands by targeting services to those considered most in need: clients with severe mental illnesses. The formal structure and program philosophy of these programs clearly reflected this emphasis; consequently, levels of goal incongruence were low and evaluations of effectiveness were high. Generalist programs continued to provide care to diverse client groups, had more professionals, offered traditional services (such as psychotherapy), and exhibited higher levels of goal incongruence; these factors resulted in lower evaluations of effectiveness. This research is important because it demonstrates that organizational processes of institutional conformity (program objectives meet the demands of external constituents) and goal congruence (program objectives meet with expectations of internal constituents) are critical to positive evaluations of effectiveness. With the current institutional demand for effective, efficient services, it is critical that researchers have a conceptual framework for analyzing those factors which influence evaluations of effectiveness.

  5. Confronting trade-offs in health care: Harvard Pilgrim Health Care's organizational ethics program.

    Science.gov (United States)

    Sabin, James E; Cochran, David

    2007-01-01

    Patients, providers, and policy leaders need a new moral compass to guide them in the turbulent U.S. health care system. Task forces have proposed excellent ethical codes, but these have been seen as too abstract to provide guidance at the front lines. Harvard Pilgrim Health Care's ten-year experience with an organizational ethics program suggests ways in which health care organizations can strengthen transparency, consumer focus, and overall ethical performance and contribute to the national health policy dialogue.

  6. Efficacy of simple integrated group rehabilitation program for patients with knee osteoarthritis: Single-blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Flávio S. da Silva, MS

    2015-06-01

    Full Text Available We investigated the role of an evidence-based integrated group rehabilitation program on the treatment of patients with knee osteoarthritis (KOA. This was a two-group, randomized controlled, 8 wk trial with 41 patients with moderate to very severe KOA. Patients were assigned to an intervention group (IG or control group (CG. After both groups had received a self-management education program, IG participants underwent a rehabilitation program, including educational aspects about KOA followed by exercises. CG participants received only general health orientation about KOA during this period. The outcome measures were the Lequesne algofunctional index; 36-Item Short Form Health Survey (SF-36; and chair-stand, sit-and-reach, timed up-and-go, and 6-minute walk tests. Analysis of covariance revealed significant postintervention improvements of IG participants compared with CG participants (p < 0.05 on Lequesne total score and pain and function subdomains; SF-36 physical function, role physical, bodily pain, general health, vitality, and role emotional subdomains; and performance assessed by chair-stand, timed up-and-go, and 6-minute walk tests. Focusing on the primary outcome (Lequesne total score, the mean +/– standard deviation after 8 wk was 5.50 +/– 2.98 for the IG and 7.87 +/– 3.48 for the CG (p = 0.009. The corresponding effect size (partial eta squared with 90% confidence interval was 0.23 (0.04–0.42, indicating a large effect. The presented rehabilitation program reduced pain and improved quality of life and function in patients with KOA.

  7. Impact of the Bienestar school-based diabetes mellitus prevention program on fasting capillary glucose levels: a randomized controlled trial.

    Science.gov (United States)

    Treviño, Roberto P; Yin, Zenong; Hernandez, Arthur; Hale, Daniel E; Garcia, Oralia A; Mobley, Connie

    2004-09-01

    To evaluate the impact of a school-based diabetes mellitus prevention program on low-income fourth-grade Mexican American children. A randomized controlled trial with 13 intervention and 14 control schools. Elementary schools in inner-city neighborhoods in San Antonio, Tex. Eighty percent of participants were Mexican American and 94% were from economically disadvantaged households. Baseline and follow-up measures were collected from 1419 (713 intervention and 706 control) and 1221 (619 intervention and 602 control) fourth-grade children, respectively. The Bienestar Health Program consists of a health class and physical education curriculum, a family program, a school cafeteria program, and an after-school health club. The objectives are to decrease dietary saturated fat intake, increase dietary fiber intake, and increase physical activity. The primary end point was fasting capillary glucose level, and the secondary end points were percentage of body fat, physical fitness level, dietary fiber intake, and dietary saturated fat intake. Fasting capillary glucose level, bioelectric impedance, modified Harvard step test, three 24-hour dietary recalls, weight, and height were collected at baseline and 8 months later. Children in the intervention arm attended an average of 32 Bienestar sessions. Mean fasting capillary glucose levels decreased in intervention schools and increased in control schools after adjusting for covariates (-2.24 mg/dL [0.12 mmol/L]; 95% confidence interval, -6.53 to 2.05 [-0.36 to 0.11 mmol/L]; P =.03). Fitness scores (P =.04) and dietary fiber intake (P =.009) significantly increased in intervention children and decreased in control children. Percentage of body fat (P =.56) and dietary saturated fat intake (P =.52) did not differ significantly between intervention and control children. This intervention showed some positive results, but additional research is needed to examine long-term benefits, translation, and cost-effectiveness.

  8. Proactive outreach for smokers using VHA mental health clinics: protocol for a patient-randomized clinical trial.

    Science.gov (United States)

    Rogers, Erin S; Fu, Steven S; Krebs, Paul; Noorbaloochi, Siamak; Nugent, Sean M; Rao, Radha; Schlede, Carolyn; Sherman, Scott E

    2014-12-17

    Persons with a mental health diagnosis have high rates of tobacco use and face numerous barriers to cessation including high levels of nicotine dependence, low rates of tobacco treatment referrals from mental health providers, and limited availability of tobacco treatment targeted to their needs. This manuscript describes the rationale and methods of a clinical trial with the following aims: 1) Compare the reach and efficacy of a proactive telephone-based tobacco cessation program for Veterans Health Administration (VHA) mental health clinic patients to VHA usual care and 2) Model longitudinal associations between baseline patient characteristics and long-term abstinence. We will use the electronic medical record to identify patients across four VHA healthcare facilities who have a clinical reminder code indicating current tobacco use in the past six months and who have had a mental health clinic visit in the past 12 months. We will send each patient an introductory letter and baseline survey. Survey respondents (N = 3840) will be randomized in a 1:1 fashion to intervention or control. Control participants will receive VHA usual care. Intervention participants will receive proactive motivational telephone outreach to offer tobacco treatment. Intervention participants interested in treatment will receive eight weeks of nicotine replacement therapy plus eight sessions of specialized telephone counseling over two months, followed by monthly maintenance counseling for four months. We will conduct telephone surveys with participants at six and 12 months to assess study outcomes. We will collect a mailed saliva sample from patients reporting 7-day abstinence on the telephone surveys. The primary outcome will be cotinine-validated abstinence at 12-month follow-up. Mental health patients are a high-risk smoking population with significant barriers to cessation. This study will evaluate the efficacy of a program that proactively reaches out to smokers with a mental health

  9. Success of the Undergraduate Public Health Program At Tulane University

    Directory of Open Access Journals (Sweden)

    Luann Ellis White

    2015-04-01

    Full Text Available Tulane University School of Public Health and Tropical Medicine (SPHTM launched the Bachelors of Science in Public Health (BSPH in 2005. The BSPH has steadily grown and comprises one third of the total enrollment in the school. A review of the organizational structure demonstrates that direct responsibility for undergraduate education by a school of public health is advantageous to the success of the program. The competency and skills-based curriculum attracts students. Outcome measures show the enrollment is steadily increasing. The majority of the BSPH graduates continue onto competitive graduate and professional degree programs. Those who seek jobs find employment related to their public health education, but outside of the traditional governmental public health agencies. The combined BSPH/MPH degree is a pipeline for students to pursue a MPH and increases the likelihood students will pursue careers in public health. The range and depth of study in the bachelors program is continually examined. Topics once within the purview of graduate education are now being incorporated into undergraduate courses. Undergraduate public health is one of a number of factors that is influencing changes in the MPH degree.

  10. Honolulu Community College Program Health Indicators: 2000-2001 Program Reviews.

    Science.gov (United States)

    Hawaii Univ., Honolulu. Honolulu Community Coll.

    This report presents an overall health summation of 21 programs offered at Honolulu Community College (Hawaii) during 2000-2001. The programs profiled are: (1) Auto Body Repair and Painting; (2) Aeronautics Maintenance Technology; (3) Administration of Justice; (4) Automotive Mechanics Technology; (5) Boat Maintenance Repair; (6) Carpentry; (7)…

  11. An Evaluation of the 4-H "Health Rocks" Program: Implications for Program Improvement

    Science.gov (United States)

    Self, Carlton; Morgan, A. Christian; Fuhrman, Nicholas E.; Navarro, Maria

    2013-01-01

    The National 4-H Council developed the Health Rocks substance abuse educational program to prevent youth from engaging in risky behaviors. The program was presented in 2010 to more than 8,000 middle school youth in Georgia. A post-then-pre evaluation was conducted with youth who completed 10 hours of instruction to determine if changes in youth…

  12. Randomized Evaluation of the Effectiveness of a Structured Educational Program for Patients With Essential Hypertension.

    Science.gov (United States)

    Perl, Sabine; Niederl, Ella; Kos, Cornelia; Mrak, Peter; Ederer, Herbert; Rakovac, Ivo; Beck, Peter; Kraler, Elisabeth; Stoff, Ingrid; Klima, Gert; Pieske, Burkert M; Pieber, Thomas R; Zweiker, Robert

    2016-07-01

    Adherence to medication and lifestyle interventions are essential keys for the management of hypertension. In this respect, a structured educational program for hypertensive patients has got remarkable merits (herz.leben). In order to determine the isolated effect of participation in the educational program, neglecting the possible impact of more intense care, this prospective multicenter randomized controlled study was designed (NCT00453037). A total of 256 patients in 13 centers were enrolled and randomly assigned to 2 groups (G). G-I (n = 137) underwent the educational program immediately (T-0), G-II (n = 119) after 6 months (T-6). Follow-up visits were done after 6 (T-6) and 12 (T-12) months. Primary endpoint was a difference in office blood pressure (BP) at T-6, when only G-I had undergone the educational program. Patients' baseline characteristics were comparable. At T-6, systolic office and home BP were significantly lower in G-I compared to G-II: office BP systolic 139 (134-150) mm Hg vs. 150 (135-165) mm Hg (P educational program differences in BP disappeared. The results of this multicenter randomized controlled study provide significant evidence for benefit by participation in a structured educational program. Positive effects seem to be mediated by better adherence and life style changes due to higher levels of information and patient empowerment. Therefore, educational strategies should be considered as standard of care for hypertensive patients. © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Linking High Risk Postpartum Women with a Technology Enabled Health Coaching Program to Reduce Diabetes Risk and Improve Wellbeing: Program Description, Case Studies, and Recommendations for Community Health Coaching Programs

    Directory of Open Access Journals (Sweden)

    Priyanka Athavale

    2016-01-01

    Full Text Available Background. Low-income minority women with prior gestational diabetes mellitus (pGDM or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is an ongoing randomized control trial (RCT evaluating a hybrid HIT/Health Coaching DPP-based 20-week postpartum program for diabetes prevention compared with education from written materials at baseline. Eligibility includes women 18–39 years old, ≥32 weeks pregnant, and GDM or BMI > 25. Clinic- and community-based recruitment in San Francisco and Sonoma Counties targets 180 women. Sociodemographic and health coaching data from a preliminary sample are presented. Results. Most of the 86 women included to date (88% have GDM, 80% were identified as Hispanic/Latina, 78% have migrant status, and most are Spanish-speaking. Women receiving the intervention indicate high engagement, with 86% answering 1+ calls. Health coaching callbacks last an average of 9 minutes with range of topics discussed. Case studies presented convey a range of emotional, instrumental, and health literacy-related supports offered by health coaches. Discussion. The DPP-adapted HIT/health coaching model highlights the possibility and challenge of delivering DPP content to postpartum women in community settings. This trial is registered with ClinicalTrials.gov NCT02240420.

  14. Feasibility and marketing studies of health sciences librarianship education programs.

    Science.gov (United States)

    Lipscomb, C E; Moran, B B; Jenkins, C G; Cogdill, K W; Friedman, C P; Gollop, C J; Moore, M E; Morrison, M L; Tibbo, H R; Wildemuth, B M

    1999-01-01

    The University of North Carolina at Chapel Hill evaluated five curricular models designed to improve education for health sciences librarianship. Three of the models enhanced existing degree and certificate programs, and two were new programs for working information professionals. Models were developed with input from experts and a Delphi study; the marketability of the models was tested through surveys of potential students and employers; and recommendations were made as a guide to implementation. The results demonstrated a demand for more specialized curricula and for retraining opportunities. Marketing data showed a strong interest from potential students in a specialized master's degree, and mid-career professionals indicated an interest in postmaster's programs that provided the ability to maintain employment. The study pointed to the opportunity for a center of excellence in health sciences information education to enable health sciences librarians to respond to their evolving roles.

  15. ANALYSIS OF FUZZY QUEUES: PARAMETRIC PROGRAMMING APPROACH BASED ON RANDOMNESS - FUZZINESS CONSISTENCY PRINCIPLE

    Directory of Open Access Journals (Sweden)

    Dhruba Das

    2015-04-01

    Full Text Available In this article, based on Zadeh’s extension principle we have apply the parametric programming approach to construct the membership functions of the performance measures when the interarrival time and the service time are fuzzy numbers based on the Baruah’s Randomness- Fuzziness Consistency Principle. The Randomness-Fuzziness Consistency Principle leads to defining a normal law of fuzziness using two different laws of randomness. In this article, two fuzzy queues FM/M/1 and M/FM/1 has been studied and constructed their membership functions of the system characteristics based on the aforesaid principle. The former represents a queue with fuzzy exponential arrivals and exponential service rate while the latter represents a queue with exponential arrival rate and fuzzy exponential service rate.

  16. Heteronormativity in health care education programs.

    Science.gov (United States)

    Röndahl, Gerd

    2011-05-01

    The Equal Opportunity Committee at the Swedish university where this study was performed has a specific plan for equality with respect to sexual orientation and gender identity which concerns both students as well as employees. The overall purpose of this study was to investigate nursing students' and medical students' experience of LGBT issues within their respective educations. A qualitative semi-structured group interview study was carried out in autumn 2007. Five nursing students and 3 medical students from semester 2 to 6 participated. The students who participated described LGBT people as an invisible minority in all circumstances and that it was not easy to discuss and promote the theme since the student risked coming out involuntarily. The students felt that teachers and administrators were too passive when it came to LGBT issues and, the students themselves felt excluded. The students felt that heteronormativity governed in both the nursing and the medical education programs. This paper suggests that the law regarding equal treatment of students must be adhered to by administrators, and universities must begin to provide education on LGBT to employees and students. So why not recruit qualified LGBT instructors and lecturers similar to the gender lecturers employed at several other universities in Sweden. Copyright © 2010. Published by Elsevier Ltd.

  17. Yoga in the treatment of eating disorders within a residential program: A randomized controlled trial.

    Science.gov (United States)

    Pacanowski, Carly R; Diers, Lisa; Crosby, Ross D; Neumark-Sztainer, Dianne

    2017-01-01

    To investigate the effect of yoga on negative affect (an eating disorders risk factor), 38 individuals in a residential eating disorder treatment program were randomized to a control or yoga intervention: 1 hour of yoga before dinner for 5 days. Negative affect was assessed pre- and post-meal. Mixed-effects models compared negative affect between groups during the intervention period. Yoga significantly reduced pre-meal negative affect compared to treatment as usual; however, the effect was attenuated post-meal. Many eating disorders programs incorporate yoga into treatment. This preliminary evidence sets the stage for larger studies examining yoga and eating disorder treatment and prevention.

  18. Randomized trial of a tailored nutrition education CD-ROM program for women receiving food assistance.

    Science.gov (United States)

    Campbell, Marci K; Carbone, Elena; Honess-Morreale, Lauren; Heisler-Mackinnon, Jennifer; Demissie, Seleshi; Farrell, David

    2004-01-01

    This article describes the development and randomized evaluation of a tailored nutrition education CD-ROM program for participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in North Carolina. After randomization to intervention or control groups, participants completed a baseline survey and were resurveyed immediately after program use and 1 to 2 months postintervention. Two WIC clinics in central North Carolina. A total of 307 respondents to the follow-up survey (response rate 74.8%) comprised the study sample. Participants were female (96%), 20% were pregnant, and 50% were minorities (African American and other). The interactive CD-ROM consisted of a targeted video soap opera, dietary assessment, and individually tailored dietary feedback and strategies for change. Measures included total fat and fruit and vegetable intake, knowledge of low-fat and infant feeding choices, self-efficacy, and stages of change. Descriptive statistics assessed baseline comparability of study groups; analysis of covariance and F tests were used to assess program effects at follow-up. INTERVENTION group members increased self-efficacy (P <.01) and scored significantly higher (P <.05) on both low-fat and infant feeding knowledge compared with controls. No differential effect was observed for dietary intake variables. The findings suggest that one dose of an interactive CD-ROM program can impact mediators of dietary change but may be insufficient to change behavior.

  19. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico

    Directory of Open Access Journals (Sweden)

    Becerril Victor

    2011-03-01

    Full Text Available Abstract Background Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Methods Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Results Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Conclusions Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives

  20. Mapping of health system functions to strengthen priority programs. The case of maternal health in Mexico.

    Science.gov (United States)

    González-Block, Miguel A; Rouvier, Mariel; Becerril, Victor; Sesia, Paola

    2011-03-15

    Health system strengthening is critical to ensure the integration and scaling-up of priority health promotion, disease prevention and control programs. Normative guidelines are available to address health system function imbalances while strategic and analytical frameworks address critical functions in complex systems. Tacit knowledge-based health system constructs can help identify actors' perspectives, contributing to improve strengthening strategies. Using maternal health as an example, this paper maps and analyses the health system functions that critical actors charged with formulating and delivering priority health programs consider important for their success. Using concept mapping qualitative and statistical methods, health system functions were mapped for different categories of actors in high maternal mortality states of Mexico and at the federal level. Functions within and across maps were analyzed for degree of classification, importance, feasibility and coding. Hospital infrastructure and human resource training are the most prominent functions in the maternal health system, associated to federal efforts to support emergency obstetric care. Health policy is a highly diffuse function while program development, intercultural and community participation and social networks are clearly stated although less focused and with lower perceived importance. The importance of functions is less correlated between federal and state decision makers, between federal decision makers and reproductive health/local health area program officers and between state decision makers and system-wide support officers. Two sets of oppositions can be observed in coding across functions: health sector vs. social context; and given structures vs. manageable processes. Concept mapping enabled the identification of critical functions constituting adaptive maternal health systems, including aspects of actor perspectives that are seldom included in normative and analytical frameworks

  1. Effectiveness of public health programs for decreasing alcohol consumption

    Directory of Open Access Journals (Sweden)

    Kelly-Weeder S

    2011-05-01

    Full Text Available Susan Kelly-Weeder, Kathryn Phillips, Shannon RounsevilleWilliam F Connell School of Nursing, Boston College, Chestnut Hill, MA, USAAbstract: Excessive alcohol consumption and the associated negative consequences are a major public health concern in the United States and throughout the world. Historically, there have been numerous attempts to develop policies and prevention programs aimed at decreasing high-risk alcohol use. Policy initiatives have demonstrated considerable effectiveness and include changes in the minimum legal drinking age, reductions in acceptable legal limits for blood alcohol concentration while operating a motor vehicle, as well as decreasing availability and access to alcohol for underage individuals. Primary prevention programs that have used exclusively educational approaches have received mixed results. Increasing effectiveness has been associated with prevention programs that have utilized a multi-component approach and have included educational initiatives with environmental changes.Keywords: alcohol abuse, underage, public health, programs, binge drinking

  2. Clinical Impact and Cost-Effectiveness of an Education Program for PD Patients: A Randomized Controlled Trial

    Science.gov (United States)

    Ory-Magne, Fabienne; Arcari, Céline; Mohara, Christine; Pourcel, Laure; Derumeaux, Hélène; Bérard, Emilie; Bourrel, Robert; Molinier, Laurent; Brefel-Courbon, Christine

    2016-01-01

    Background Parkinson’s disease (PD) is characterized by its impact on quality of life, constituting a substantial economic burden on society. Education programs implicating patients more in the management of their illness and complementing medical treatment may be a beneficial adjunct in PD. This study assessed the impact of an education program on quality of life and its cost-effectiveness in PD patients. Methods This single-center, prospective, randomized study assessed an education program consisting of individual and group sessions over a 12-month period. A total of 120 PD patients were assigned to either the Treated by Behavioral Intervention group (TTBI) or the no TTBI group. The primary outcome criterion was quality of life assessed using PDQ39. The Unified Parkinson’s Disease Rating Scale (UPDRS) and psychological status were collected. An economic evaluation was performed, including calculations of incremental cost-effectiveness ratios (ICERs). Results After 12 months of follow-up, changes recorded in the PDQ39 between the groups were not significantly different but better changes were observed in each dimension in the TTBI group compared to the no TTBI group. UPDRS I, II and total score were significantly improved in TTBI group compared to the no TTBI group. Mean annual costs did not differ significantly between the two groups. Conclusion This study suggested that the education program positively impacts the perceived health of PD patients without increasing medical costs. PMID:27685455

  3. Effect of yoga program on executive functions of adolescents dwelling in an orphan home: A randomized controlled study.

    Science.gov (United States)

    Purohit, Satya Prakash; Pradhan, Balaram

    2017-01-01

    Executive function (EF) is important for physical and mental health of children. Studies have shown that children with poverty and early life stress have reduced EF. The aim of the study was to evaluate the effect of Yoga program on the EF of orphan adolescents. Seventy two apparently healthy orphan adolescents randomized and allocated into two groups as Yoga group (n = 40; 14 girls, age = 12.69 ± 1.35 yrs) and Wait List Control (WLC) group (n = 32, 13 girls, age = 12.58 ± 1.52 yrs). Yoga group underwent three months of Yoga program in a schedule of 90 min per day, four days per week whereas the WLC group followed the routine activities. They were assessed by Stroop Color-Word Task, Digit Symbol Substitution Test (DSST), Digits Span Test and Trial Making Test (TMT) at the beginning and end of the program. The repeated measures ANOVA showed significant difference in time and group interactions (p Yoga group in all test scores while in wrong score of DSST did not exhibit significant reduction. Whereas the WLC group, showed significant improvement (p Yoga program was found useful for the young orphan adolescents in improving their executive functions.

  4. Bias analysis applied to Agricultural Health Study publications to estimate non-random sources of uncertainty

    Directory of Open Access Journals (Sweden)

    Lash Timothy L

    2007-11-01

    Full Text Available Abstract Background The associations of pesticide exposure with disease outcomes are estimated without the benefit of a randomized design. For this reason and others, these studies are susceptible to systematic errors. I analyzed studies of the associations between alachlor and glyphosate exposure and cancer incidence, both derived from the Agricultural Health Study cohort, to quantify the bias and uncertainty potentially attributable to systematic error. Methods For each study, I identified the prominent result and important sources of systematic error that might affect it. I assigned probability distributions to the bias parameters that allow quantification of the bias, drew a value at random from each assigned distribution, and calculated the estimate of effect adjusted for the biases. By repeating the draw and adjustment process over multiple iterations, I generated a frequency distribution of adjusted results, from which I obtained a point estimate and simulation interval. These methods were applied without access to the primary record-level dataset. Results The conventional estimates of effect associating alachlor and glyphosate exposure with cancer incidence were likely biased away from the null and understated the uncertainty by quantifying only random error. For example, the conventional p-value for a test of trend in the alachlor study equaled 0.02, whereas fewer than 20% of the bias analysis iterations yielded a p-value of 0.02 or lower. Similarly, the conventional fully-adjusted result associating glyphosate exposure with multiple myleoma equaled 2.6 with 95% confidence interval of 0.7 to 9.4. The frequency distribution generated by the bias analysis yielded a median hazard ratio equal to 1.5 with 95% simulation interval of 0.4 to 8.9, which was 66% wider than the conventional interval. Conclusion Bias analysis provides a more complete picture of true uncertainty than conventional frequentist statistical analysis accompanied by a

  5. An interactive computer program for randomization analysis of response curves with facilities for multiple comparisons.

    Science.gov (United States)

    Tan, E S; Roos, J M; Volovics, A; Van Baak, M A; Does, R J

    1992-04-01

    An interactive Fortran program, MUCRA, is presented. The program can perform randomization analysis of a completely randomized or randomized-blocks design extended to growth and response curves. A single-step Scheffé-type procedure as well as the Peritz's closed step-down procedure have been implemented which control the familywise type I error-rate. In general, MUCRA is suitable as a computer tool for a distribution-free analysis of variance with repeated measures. The use of MUCRA is demonstrated by analyzing the effects oxprenolol and atenolol have on exercise heart rate. Oxprenolol is a non-selective beta-blocker with moderate intrinsic sympathomimetic activity (ISA), given by the Oros delivery system. Atenolol is a beta 1-selective blocker without ISA. A randomized placebo-controlled crossover design was used to compare the effects of the beta 1-blockers on heart rate during a progressive maximal exercise test on a bicycle ergometer. Application of the Scheffé-type procedure showed that the two drugs significantly (alpha = .05) reduce the heart rate during the exercise test at the three prechosen times (2, 5, and 24 hr) after intake. The reduction from atenolol is more pronounced than from oxprenolol Oros at 2 and 5 hr.

  6. Effects of a group-focused cognitive behavioral health education program on cigarette smoking in a sample of Nigerian prisoners

    OpenAIRE

    Onyechi, Kay C.N.; Eseadi, Chiedu; Umoke, Prince C.I.; Ikechukwu-Ilomuanya, Amaka B.; Otu, Mkpoikanke S.; Obidoa, Jaachimma C.; Agu, Fedinand U.; Nwaubani, Okechukwu O.; Utoh-Ofong, Anthonia N.; Ncheke, Chijioke D.; Ugwuozor, Felix O.

    2017-01-01

    Abstract Background: Smoking is a learned habit that has an impact on the psychological and biochemical health of individuals. It is the leading preventable cause of chronic illness worldwide. The purpose of this study was to examine the effects of a group-focused cognitive behavioral health education program (GCBHEP) on cigarette smoking in a sample of Nigerian prisoners. Methods: The study used a pretest–posttest randomized control group design. Twenty inmates were identified through self-r...

  7. Building a sustainable comprehensive Women's Health Program: the Michigan model.

    Science.gov (United States)

    Rogers, Juliet L; Johnson, Timothy R B; Warner, Patricia; Thorson, Jayne A; Punch, Margaret R

    2007-01-01

    The Women's Health Program at the University of Michigan was established in 1993 and has developed into a successful, federally supported program that links clinical research and education activities across the University. It has focused on human resource capacity building, sustainable financial support and infrastructure, and adaptability to change and opportunities. Widely accepted standards, demonstrated value, committed leaders/champions, and participatory culture have contributed to its success and are important to its future.

  8. Worksite health and wellness programs: Canadian achievements & prospects.

    Science.gov (United States)

    Després, Jean-Pierre; Alméras, Natalie; Gauvin, Lise

    2014-01-01

    Canada has experienced a substantial reduction in mortality related to cardiovascular disease (CVD). There is a general consensus that more effective and widespread health promotion interventions may lead to further reductions in CVD risk factors and actual disease states. In this paper, we briefly outline the prevalence of selected risk factors for CVD in Canada, describe characteristics of the Canadian labor market and workforce, and depict what is known about health and wellness program delivery systems in Canadian workplaces. Our review indicates that there have been numerous and diverse relevant legislative and policy initiatives to create a context conducive to improve the healthfulness of Canadian workplaces. However, there is still a dearth of evidence on the effectiveness of the delivery system and the actual impact of workplace health and wellness programs in reducing CVD risk in Canada. Thus, while a promising model, more research is needed in this area.

  9. The Effects of a Community-Based Sodium Reduction Program in Rural China – A Cluster-Randomized Trial

    Science.gov (United States)

    Yan, Lijing L.; Niu, Wenyi; Yao, Chen; Feng, Xiangxian; Zhang, Jianxin; Shi, Jingpu; Zhang, Yuhong; Zhang, Ruijuan; Hao, Zhixin; Chu, Hongling; Zhang, Jing; Li, Xian; Pan, Jianhong; Li, Zhifang; Sun, Jixin; Zhou, Bo; Zhao, Yi; Yu, Yan; Engelgau, Michael; Labarthe, Darwin; Ma, Jixiang; MacMahon, Stephen; Elliott, Paul; Wu, Yangfeng; Neal, Bruce

    2016-01-01

    Background Average sodium intake and stroke mortality in northern China are both among the highest in the world. An effective, low-cost strategy to reduce sodium intake in this population is urgently needed. Objective We sought to determine the effects of a community-based sodium reduction program on salt consumption in rural northern China. Design This study was a cluster-randomized trial done over 18 months in 120 townships (one village from each township) from five provinces. Sixty control villages were compared to 60 intervention villages that were given access to a reduced-sodium, added-potassium salt substitute in conjunction with a community-based health education program focusing on sodium reduction. The primary outcome was the difference in 24-hour urinary sodium excretion between randomized groups. Results Among 1,903 people with valid 24-hour urine collections, mean urinary sodium excretion in intervention compared with control villages was reduced by 5.5% (-14mmol/day, 95% confidence interval -26 to -1; p = 0.03), potassium excretion was increased by 16% (+7mmol/day, +4 to +10; psalt substitute. The absence of effects on blood pressure reflects the moderate changes in sodium and potassium intake achieved. Trial Registration Clinicaltrials.gov identifier: NCT01259700. PMID:27935977

  10. Teaching children about mental health and illness: a school nurse health education program.

    Science.gov (United States)

    Desocio, Janiece; Stember, Lisa; Schrinsky, Joanne

    2006-04-01

    A mental health education program designed by school nurses for children ages 10- 12 was developed in 2000-2001 and expanded with broader distribution in 2004-2005. Six classroom sessions, each 45 minutes in length, provided information and activities to increase children's awareness of mental health and illness. Education program content included facts about the brain's connection to mental health, information about healthy ways to manage stress, resources and activities to promote mental health, common mental health problems experienced by children, and how to seek help for mental health problems. Classes included a combination of didactic presentation and open discussion, encouraging students to ask questions and allowing the school nurse to correct misinformation. Analysis of pre- and posttests from 370 elementary and middle school students revealed statistically significant improvements in their knowledge of mental health and mental illness.

  11. Developing built environment programs in local health departments: lessons learned from a nationwide mentoring program.

    Science.gov (United States)

    Rube, Kate; Veatch, Maggie; Huang, Katy; Sacks, Rachel; Lent, Megan; Goldstein, Gail P; Lee, Karen K

    2014-05-01

    Local health departments (LHDs) have a key role to play in developing built environment policies and programs to encourage physical activity and combat obesity and related chronic diseases. However, information to guide LHDs' effective engagement in this arena is lacking. During 2011-2012, the New York City Department of Health and Mental Hygiene (DOHMH) facilitated a built environment peer mentoring program for 14 LHDs nationwide. Program objectives included supporting LHDs in their efforts to achieve built environment goals, offering examples from DOHMH's built environment work to guide LHDs, and building a healthy built environment learning network. We share lessons learned that can guide LHDs in developing successful healthy built environment agendas.

  12. Sleep Promotion Program for Improving Sleep Behaviors in Adolescents: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Bindu John

    2016-01-01

    Full Text Available Aims. The purpose of this pilot trial was to determine the efficacy of sleep promotion program to adapt it for the use of adolescents studying in various schools of Mangalore, India, and evaluate the feasibility issues before conducting a randomized controlled trial in a larger sample of adolescents. Methods. A randomized controlled trial design with stratified random sampling method was used. Fifty-eight adolescents were selected (mean age: 14.02 ± 2.15 years; intervention group, n=34; control group, n=24. Self-report questionnaires, including sociodemographic questionnaire with some additional questions on sleep and activities, Sleep Hygiene Index, Pittsburgh Sleep Quality Index, The Cleveland Adolescent Sleepiness Questionnaire, and PedsQL™ Present Functioning Visual Analogue Scale, were used. Results. Insufficient weekday-weekend sleep duration with increasing age of adolescents was observed. The program revealed a significant effect in the experimental group over the control group in overall sleep quality, sleep onset latency, sleep duration, daytime sleepiness, and emotional and overall distress. No significant effect was observed in sleep hygiene and other sleep parameters. All target variables showed significant correlations with each other. Conclusion. The intervention holds a promise for improving the sleep behaviors in healthy adolescents. However, the effect of the sleep promotion program treatment has yet to be proven through a future research. This trial is registered with ISRCTN13083118.

  13. A randomized comparative effectiveness trial of using cable television to deliver diabetes prevention programming.

    Science.gov (United States)

    Ackermann, Ronald T; Sandy, Lewis G; Beauregard, Tom; Coblitz, Mark; Norton, Kristi L; Vojta, Deneen

    2014-07-01

    To evaluate the use and effectiveness of two "in-home" strategies for delivering diabetes prevention programming using cable television. An individually randomized, two-arm intervention trial including adults with diabetes risk factors living in two US cities. Interventions involved a 16-session lifestyle intervention delivered via "video-on-demand" cable television, offered alone versus in combination with web-based lifestyle support tools. Repeated measures longitudinal linear regression with imputation of missing observations was used to compare changes in body weight. A total of 306 individuals were randomized and offered the interventions. After 5 months, 265 (87%) participants viewed at least 1, and 110 (36%) viewed ≥9 of the video episodes. A total of 262 (86%) participants completed a 5-month weight measurement. In intention-to-treat analysis with imputation of missing observations, mean weight loss at 5 months for both treatment groups combined was 3.3% (95% CI 0.7-5.0%), regardless of intervention participation (with no differences between randomized groups (P = 0.19)), and was 4.9% (95% CI 2.1-6.5%) for participants who viewed ≥9 episodes. In-home delivery of evidence-based diabetes prevention programming in a reality television format, offered with or without online behavioral support tools, can achieve modest weight losses consistent with past implementation studies of face-to-face programs using similar content. © 2014 The Authors Obesity published by Wiley Periodicals, Inc. on behalf of The Obesity Society (TOS).

  14. Effects of an Interactive School-Based Program for Preventing Adolescent Sexual Harassment: A Cluster-Randomized Controlled Evaluation Study.

    Science.gov (United States)

    de Lijster, Gaby P A; Felten, Hanneke; Kok, Gerjo; Kocken, Paul L

    2016-05-01

    Many adolescents experience sexual harassment and victims of sexual harassment have higher risks regarding well-being and health behaviors such as higher risks of suicidal thoughts, suicidal ideation and feeling unsafe at school. A peer-performed play and school lessons on preventing sexual harassment behavior were presented to secondary school students. We evaluated its effectiveness, using a cluster-randomized controlled design to assign schools to an experimental condition [n = 14 schools; 431 students (51 % female)] and a control condition [n = 11 schools; 384 students (51 % female)]. To measure the effects of the intervention at first post-test and 6-month follow-up, our multilevel analyses used a two-level random intercept model. Outcome measures were sexual harassment behaviors, behavioral determinants and distal factors influencing these behaviors. At post-test, students in the experimental group reported a reduced intention to commit sexual harassment behavior and higher self-efficacy in rejecting it. At post-test and follow-up there was a significant positive effect on social norms for rejecting sexual harassment behavior. At follow-up, sexual self-esteem was higher in students in the experimental group than in the control group. Effects on these determinants will benefit adolescents' future sexual behaviors. In combination, the play and lessons, possibly together with continued sexual health education and skills programs on social-emotional learning in subsequent school years, have potential for preventing sexual harassment behavior.

  15. 42 CFR 431.636 - Coordination of Medicaid with the Children's Health Insurance Program (CHIP).

    Science.gov (United States)

    2010-10-01

    ... Insurance Program (CHIP). 431.636 Section 431.636 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES...'s Health Insurance Program (CHIP). (a) Statutory basis. This section implements— (1) Section 2102(b... coordination between a State child health program and other public health insurance programs. (b) Obligations...

  16. Electronic Health Record Vendors Reported by Health Care Providers Participating in Federal EHR Incentive Programs

    Data.gov (United States)

    U.S. Department of Health & Human Services — This public use file combines registration data compiled from two federal programs that are on-going since February 2009 – the Centers for Medicare & Medicaid...

  17. FAMILY HEALTH PROGRAM: CHALLENGES AND POTENTIALITIES REGARDING DRUGS USE

    Directory of Open Access Journals (Sweden)

    Marcelle Aparecida de Barros

    2006-04-01

    Full Text Available ABSTRACT: Epidemiological studies on drugs use point towards this phenomenon as a public health problem. Nowadays, the Family Health Program (FHP is presented by the Health Ministry as a model to restructure primary health care and aims to offer family-centered care, permeated by integrality, problem solving and community bonds. This article aims to discuss action possibilities of Family Health Care professionals involving drugs patients. It is evident that, as opposed to other actions already developed by FHP professionals in other health care areas, which has appeared clearly and objectively. This fact is observed in the daily activities of FHP professionals, which give little attention to drugs-related problems. However, research emphasizes that there exists a broad range of action possibilities for FHP professionals. Although other studies evidence this team’s fragilities in terms of care for drugs users, these can be overcome by investing in the training and valuation of these professionals. KEY WORDS: Family Health Program; Street drugs; Health Knowledge, Attitudes, Practice.

  18. Effectiveness of a web-based education program to improve vaccine storage conditions in primary care (Keep Cool): study protocol for a randomized controlled trial

    OpenAIRE

    Thielmann, Anika; Viehmann, Anja; Weltermann, Birgitta M

    2015-01-01

    Background Immunization programs are among the most effective public health strategies worldwide. Adequate vaccine storage is a prerequisite to assure the vaccines’ effectiveness and safety. In a questionnaire survey among a random sample of German primary care physicians, we discovered vaccine storage deficits: 16 % of physicians had experience with cold chain breaches either as an error or near error, 49 % did not keep a temperature log, and 21 % did not use a separate refrigerator for vacc...

  19. 25 CFR 36.97 - What basic requirements must a program's health services meet?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What basic requirements must a program's health services... SITUATIONS Homeliving Programs Program Requirements § 36.97 What basic requirements must a program's health... necessary health services for all students residing in the homeliving program, subject to agreements between...

  20. 25 CFR 36.91 - What are the program requirements for behavioral health services?

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false What are the program requirements for behavioral health... SITUATIONS Homeliving Programs Program Requirements § 36.91 What are the program requirements for behavioral health services? (a) The homeliving behavioral health program must make available the following services...

  1. Program home visit Costa Rica's health system: guidelines for improvement

    Directory of Open Access Journals (Sweden)

    Katherine Solís Cordero

    2015-07-01

    Full Text Available Introduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service.Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system.Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

  2. Efficacy of smoking prevention program 'Smoke-free Kids': study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Schayck Onno CP

    2009-12-01

    Full Text Available Abstract Background A strong increase in smoking is noted especially among adolescents. In the Netherlands, about 5% of all 10-year olds, 25% of all 13-year olds and 62% of all 17-year olds report ever smoking. In the U.S., an intervention program called 'Smoke-free Kids' was developed to prevent children from smoking. The present study aims to assess the effects of this home-based smoking prevention program in the Netherlands. Methods/Design A randomized controlled trial is conducted among 9 to 11-year old children of primary schools. Participants are randomly assigned to the intervention and control conditions. The intervention program consists of five printed activity modules designed to improve parenting skills specific to smoking prevention and parent-child communication regarding smoking. These modules will include additional sheets with communication tips. The modules for the control condition will include solely information on smoking and tobacco use. Initiation of cigarette smoking (first instance of puffing on a lighted cigarette, susceptibility to cigarette smoking, smoking-related cognitions, and anti-smoking socialization will be the outcome measures. To collect the data, telephone interviews with mothers as well as with their child will be conducted at baseline. Only the children will be examined at post-intervention follow-ups (6, 12, 24, and 36 months after the baseline. Discussion This study protocol describes the design of a randomized controlled trial that will evaluate the effectiveness of a home-based smoking prevention program. We expect that a significantly lower number of children will start smoking in the intervention condition compared to control condition as a direct result of this intervention. If the program is effective, it is applicable in daily live, which will facilitate implementation of the prevention protocol. Trial registration Netherlands Trial Register NTR1465

  3. Population-level effects of automated smoking cessation help programs: a randomized controlled trial.

    Science.gov (United States)

    Borland, Ron; Balmford, James; Benda, Peter

    2013-03-01

    To test the population impact of offering automated smoking cessation interventions via the internet and/or by mobile phone. Pragmatic randomized controlled trial with five conditions: offer of (i) minimal intervention control; (ii) QuitCoach personalized tailored internet-delivered advice program; (iii) onQ, an interactive automated text-messaging program; (iv) an integration of both QuitCoach and onQ; and (v) a choice of either alone or the combined program. Australia, via a mix of internet and telephone contacts. A total of 3530 smokers or recent quitters recruited from those interested in quitting, and seeking self-help resources (n = 1335) or cold-contacted from internet panels (n = 2195). The primary outcome was self-report of 6 months sustained abstinence at 7 months post-recruitment. Only 42.5% of those offered one of the interventions took it up to a minimal level. The intervention groups combined had a non-significantly higher 6-month sustained abstinence rate than the control [odds ratio (OR) = 1.48; 95% confidence interval (CI): 0.98-2.24] (missing cases treated as smokers), with no differences between the interventions. Among those who used an intervention, there was a significant overall increase in abstinence (OR = 1.95; CI: 1.04-3.67), but not clearly so when analysing only cases with reported outcomes. Success rates were greater among those recruited after seeking information compared to those cold-contacted. Smokers interested in quitting who were assigned randomly to an offer of either the QuitCoach internet-based support program and/or the interactive automated text-messaging program had non-significantly greater odds of quitting for at least 6 months than those randomized to an offer of a simple information website. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  4. Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378

    OpenAIRE

    Ewings Paul E; Reeves Barnaby C; Taylor Rod S; Taylor Rebecca J

    2004-01-01

    Abstract Introduction Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals. Methods This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West...

  5. Effects of vitamin E supplementation on some pregnancy health indices: a randomized clinical trial

    OpenAIRE

    Bastani P; Hamdi K; Abasalizadeh F; Navali N

    2011-01-01

    Parvin Bastani, Kobra Hamdi, Fatemeh Abasalizadeh, Nazli NavaliWomen's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, IranObjective: Available evidence about the role of supplementary vitamin E in normal pregnancy is inadequate. This study assessed the potential benefit of vitamin E supplementation on some pregnancy health indices.Methods: A 1:2 weighted simple randomization technique was used to allocate 104 eligible pregnant women to receive vita...

  6. Effectiveness of exercise programs in ankylosing spondylitis: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Pécourneau, Virginie; Degboé, Yannick; Barnetche, Thomas; Cantagrel, Alain; Constantin, Arnaud; Ruyssen-Witrand, Adeline

    2017-08-28

    To assess the effectiveness of exercise programs on disease activity and function in ankylosing spondylitis (AS) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Medline via PubMed and Cochrane Library. Reports of RCTs examining the effectiveness of exercise programs for AS published up to May 2017. Outcomes were evolution of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) after the completion of exercise programs. Modalities of exercise were compared and the use of biologic therapy was reported. After screening 190 abstracts, we selected 26 reports for detailed evaluation and finally investigated 8 trials that assessed a home-based exercise program (2/8), swimming (1/8), Pilates training (1/8) or supervised exercises (4/8), for 331 AS patients. Four trials included patients receiving anti-TNF therapy. All trials except one showed a decrease in BASDAI and BASFI, with exercise. The weighted mean difference (95% confidence interval) was -0.90 (-1.52, -0.27) (I(2)=69%, p=0.005) for the BASDAI and -0.72 (-1.03, -0.40) (I(2)= 0%, pexercise programs. Despite the small number of patients and the heterogeneity of exercise programs in the RCTs included in this meta-analysis, its results support the potential of exercise programs to improve disease activity and body function in AS. Copyright © 2017. Published by Elsevier Inc.

  7. Patient engagement programs for recognition and initial treatment of depression in primary care: a randomized trial.

    Science.gov (United States)

    Kravitz, Richard L; Franks, Peter; Feldman, Mitchell D; Tancredi, Daniel J; Slee, Christina A; Epstein, Ronald M; Duberstein, Paul R; Bell, Robert A; Jackson-Triche, Maga; Paterniti, Debora A; Cipri, Camille; Iosif, Ana-Maria; Olson, Sarah; Kelly-Reif, Steven; Hudnut, Andrew; Dvorak, Simon; Turner, Charles; Jerant, Anthony

    2013-11-06

    Encouraging primary care patients to address depression symptoms and care with clinicians could improve outcomes but may also result in unnecessary treatment. To determine whether a depression engagement video (DEV) or a tailored interactive multimedia computer program (IMCP) improves initial depression care compared with a control without increasing unnecessary antidepressant prescribing. Randomized clinical trial comparing DEV, IMCP, and control among 925 adult patients treated by 135 primary care clinicians (603 patients with depression and 322 patients without depression, defined by Patient Health Questionnaire-9 [PHQ-9] score) conducted from June 2010 through March 2012 at 7 primary care clinical sites in California. DEV targeted to sex and income, an IMCP tailored to individual patient characteristics, and a sleep hygiene video (control). Among depressed patients, superiority assessment of the composite measure of patient-reported antidepressant drug recommendation, mental health referral, or both (primary outcome); depression at 12-week follow-up, measured by the PHQ-8 (secondary outcome). Among nondepressed patients, noninferiority assessment of clinician- and patient-reported antidepressant drug recommendation (primary outcomes) with a noninferiority margin of 3.5%. Analyses were cluster adjusted. Of the 925 eligible patients, 867 were included in the primary analysis (depressed, 559; nondepressed, 308). Among depressed patients, rates of achieving the primary outcome were 17.5% for DEV, 26% for IMCP, and 16.3% for control (DEV vs control, 1.1 [95% CI, -6.7 to 8.9], P = .79; IMCP vs control, 9.9 [95% CI, 1.6 to 18.2], P = .02). There were no effects on PHQ-8 measured depression score at the 12-week follow-up: DEV vs control, -0.2 (95% CI, -1.2 to 0.8); IMCP vs control,  0.9 (95% CI, -0.1 to 1.9). Among nondepressed patients, clinician-reported antidepressant prescribing in the DEV and IMCP groups was noninferior to control (mean percentage point

  8. National Integrated School Health Screening Program in Iran

    Directory of Open Access Journals (Sweden)

    A Amirkhani

    2009-03-01

    Full Text Available "nBackground: Screening program in schools are designed to identify children who have early signs of health problems. This study provides information about the findings of national screening program in Iran."nMethods: This national program is conducted by the Ministry of Health& Medical Education (MOHME with collaboration of the Ministry of Education & Training. This program had two major parts including 1 screening of behavioral, hearing and visual disorders, pediculosis and calculating body mass index and 2 physical examination of students, conducted by pri­mary care physicians. All services are offered free of charge. The students' parents are informed about the health status of their children."nResults: The screening program conducted in 2007-2008 included 3,124,021 students from 33 cities who were studying in the first- and third- grade- students in elementary schools, first- grade- students in middle and high schools. Of total students stud­ied, 12.48% had weight disorders, i.e. body mass index <3rd percentile or > 95th percentile. 4.77% had visual disorders, 3.95 % had head lice, 2.24% had behavioral disorders, and 0.6% had hearing disorders."nConclusion: In addition to its benefits to the students' health status, the results of this screening program help health policy mak­ers to design interventions for prevention and or early detection and treatment of the most common disorders docu­mented among school students. "n 

  9. The birth of national mental health program for India.

    Science.gov (United States)

    Wig, Narendra Nath; Murthy, Srinivasa R

    2015-01-01

    The adoption of the National Mental Health Programme (NMHP) in August 1982 was a milestone in the history of Indian psychiatry. Such an ambitious program was formulated at a time where there were <1000 psychiatrists is a triumph of need for mental health care in the country. The story of the NMHP, both in terms of the technical forces and the personalities needs to be recorded for posterity. The current article recalls the community mental health initiatives of Bengaluru and Chandigarh centers providing the reason for integrating mental health care with general health care and the support of the World Health Organization, along with the role of mental health professionals and the health administrators. The lesson that come through is the value of working together with different professionals for the common good. Recording the events for posterity is especially timely in view of the formulation of a new mental health policy and the revision of the national health policy during the last few months.

  10. Preventive Adolescent Health Care in Family Practice: A Program Summary

    Directory of Open Access Journals (Sweden)

    Barry Knishkowy

    2006-01-01

    Full Text Available The AMA Guidelines for Adolescent Preventive Services (GAPS has been the cornerstone of preventive care for teenagers since its publication in 1994. Despite this, there has been little documentation of their implementation in the family medicine literature. This article gives an overview of a family practice–based adolescent preventive health program based on GAPS recommendations, and reports on compliance, feasibility and health issues. A Community-Oriented Primary Care (COPC program targeted all adolescent patients aged 12—18 years in two Israeli family practices. 321 teenagers were invited to participate. Every 7th and 10th grader was invited for a preventive health visit with the family physician and nurse. The visits included a medical evaluation, screening and counseling regarding health issues recommended by GAPS, and counseling regarding personal health concerns. Parents were also invited to meet with the staff. 184 (57% of the adolescents invited for health visits attended. The overall visit time was 47 minutes, including 12 minutes for a questionnaire and 35 minutes with providers. Common biomedical problems included overweight, acne and dysmenorrhea. Health risk behaviors and psychosocial problems included cigarette or alcohol use, dieting, infrequent/never seat belt use, and feeling depressed. 78% wanted to discuss at least one personal health issue. 27% were invited for follow-up visits. Only 3% of the parents came for visits. A community-oriented approach facilitates bringing adolescents for preventive health visits. Many previously undetected health issues, particularly psychosocial and behavioral, are revealed during these visits. A concerns checklist aids in addressing personal health concerns.

  11. A comparison of two stretching programs for hamstring muscles: A randomized controlled assessor-blinded study.

    Science.gov (United States)

    Demoulin, Christophe; Wolfs, Sébastien; Chevalier, Madeline; Granado, Caroline; Grosdent, Stéphanie; Depas, Yannick; Roussel, Nathalie; Hage, Renaud; Vanderthommen, Marc

    2016-01-01

    Most parameters regarding hamstring flexibility training programs have been investigated; however, the joint (i.e. hip or knee) on which the stretching should preferentially be focused needs to be further explored. This randomized controlled assessor-blinded study aimed to investigate the influence of this parameter. We randomly assigned 111 asymptomatic participants with tight hamstring muscles in three groups: a control group and two groups following a different home-based 8-week (five 10-minute sessions per week) hamstring stretching program (i.e. stretching performed by flexing the hip while keeping the knee extended [SH] or by first flexing the hip with a flexed knee and then extending the knee [SK]). Range of motion (ROM) of hip flexion and knee extension were measured before and after the stretching program by means of the straight leg raising test and the passive knee extension angle test, respectively. Eighty-nine participants completed the study. A significant increase in ROM was observed at post-test. Analyses showed significant group-by-time interactions for changes regarding all outcomes. Whereas the increase in hip flexion and knee extension ROM was higher in the stretching groups than in the CG (especially for the SH group p stretching groups were observed (p > 0.05). In conclusion, the fact that both stretching programs resulted in similar results suggests no influence of the joint at which the stretching is focused upon, as assessed by the straight leg raising and knee extension angle tests.

  12. HealthScope: a model for a low cost health education program using commercial television.

    Science.gov (United States)

    Braun, K L; Conybeare, C R

    1995-01-01

    HealthScope is a health education based on the Health Belief Model that uses television and print materials. It was designed for a number of agendas--(a) a desire by health educators to provide health information to a broad audience at a reasonable cost (b) a desire by the local medical association to promote its role in prevention and primary care, and (c) a desire by commercial television to expand its coverage of local health issues in a cost-effective way. In its summer series, HealthScope included 10 weekly television programs that focused on various aspects of disease prevention and health promotion and answered viewers' questions on the air. Each program was followed by a bank of physicians answering questions on the telephone for 90 minutes. Corresponding fact sheets were distributed through a local pharmacy chain. A "healthy weekend" sweepstakes contest also was held. Intermediate outcome measures indicated that HealthScope had a broad reach and stimulated viewers to seek additional information about health. At the same time, the program generated revenue for the commercial television station.

  13. Effects of Yoga on Stress, Stress Adaption, and Heart Rate Variability Among Mental Health Professionals--A Randomized Controlled Trial.

    Science.gov (United States)

    Lin, Shu-Ling; Huang, Ching-Ya; Shiu, Shau-Ping; Yeh, Shu-Hui

    2015-08-01

    Mental health professionals experiencing work-related stress may experience burn out, leading to a negative impact on their organization and patients. The aim of this study was to examine the effects of yoga classes on work-related stress, stress adaptation, and autonomic nerve activity among mental health professionals. A randomized controlled trial was used, which compared the outcomes between the experimental (e.g., yoga program) and the control groups (e.g., no yoga exercise) for 12 weeks. Work-related stress and stress adaptation were assessed before and after the program. Heart rate variability (HRV) was measured at baseline, midpoint through the weekly yoga classes (6 weeks), and postintervention (after 12 weeks of yoga classes). The results showed that the mental health professionals in the yoga group experienced a significant reduction in work-related stress (t = -6.225, p yoga and control groups, we found the yoga group significantly decreased work-related stress (t = -3.216, p = .002), but there was no significant change in stress adaptation (p = .084). While controlling for the pretest scores of work-related stress, participants in yoga, but not the control group, revealed a significant increase in autonomic nerve activity at midpoint (6 weeks) test (t = -2.799, p = .007), and at posttest (12 weeks; t = -2.099, p = .040). Because mental health professionals experienced a reduction in work-related stress and an increase in autonomic nerve activity in a weekly yoga program for 12 weeks, clinicians, administrators, and educators should offer yoga classes as a strategy to help health professionals reduce their work-related stress and balance autonomic nerve activities. © 2015 The Authors. Worldviews on Evidence-Based Nursing published by Wiley Periodicals, Inc. on behalf of Society for Worldviews on Evidence-Based Nursing.

  14. 78 FR 54255 - HRSA's Bureau of Health Professions Advanced Education Nursing Traineeship Program

    Science.gov (United States)

    2013-09-03

    ... HUMAN SERVICES Health Resources and Services Administration HRSA's Bureau of Health Professions Advanced Education Nursing Traineeship Program AGENCY: Health Resources and Services Administration (HRSA), HHS... Education Nursing Traineeship (AENT) program. Effective fiscal year (FY) 2014, AENT support for...

  15. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

    Science.gov (United States)

    2012-10-02

    ... HUMAN SERVICES Health Resources and Services Administration Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources and Services Administration (HRSA... Services Administration (HRSA) will offer noncompetitive program expansion supplements of $100,000 to...

  16. Passage Meditation Reduces Perceived Stress in Health Professionals: A Randomized, Controlled Trial

    Science.gov (United States)

    Oman, Doug; Hedberg, John; Thoresen, Carl E.

    2006-01-01

    The authors evaluated an 8-week, 2-hr per week training for physicians, nurses, chaplains, and other health professionals using nonsectarian, spiritually based self-management tools based on passage meditation (E. Easwaran, 1978/1991). Participants were randomized to intervention (n = 27) or waiting list (n = 31). Pretest, posttest, and 8-and…

  17. Efficacy of a family practice-based lifestyle intervention program to increase physical activity and reduce clinical and physiological markers of vascular health in patients with high normal blood pressure and/or high normal blood glucose (SNAC: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Overend Tom

    2011-02-01

    Full Text Available Abstract Background Previous interventions to increase physical activity and reduce cardiovascular risk factors have been targeted at individuals with established disease; less attention has been given to intervention among individuals with high risk for disease nor has there been determination of the influence of setting in which the intervention is provided. In particular, family practice represents an ideal setting for the provision and long-term maintenance of lifestyle interventions for patients at risk (ie high-normal blood pressure or impaired glucose tolerance. Methods/design The Staged Nutrition and Activity Counseling (SNAC study is a randomized clustered design clinical trial that will investigate the effectiveness and efficacy of a multi-component lifestyle intervention on cardiovascular disease risk factors and vascular function in patients at risk in primary care. Patients will be randomized by practice to either a standard of care lifestyle intervention or a behaviourally-based, matched prescriptive physical activity and diet change program. The primary goal is to increase physical activity and improve dietary intake according to Canada's Guides to Physical Activity Healthy Eating over 24 months. The primary intention to treat analysis will compare behavioral, physiological and metabolic outcomes at 6, 12 and 24 months post-randomization including estimation of incident hypertension and/or diabetes. Discussion The design features of our trial, and the practical problems (and solutions associated with implementing these design features, particularly those that result in potential delay between recruitment, baseline data collection, randomization, intervention, and assessment will be discussed. Results of the SNAC trial will provide scientific rationale for the implementation of this lifestyle intervention in primary care. Trial registration ISRCTN: ISRCTN:42921300

  18. A Randomized Controlled Study of Manikin Simulator Fidelity on Neonatal Resuscitation Program Learning Outcomes

    Science.gov (United States)

    Curran, Vernon; Fleet, Lisa; White, Susan; Bessell, Clare; Deshpandey, Akhil; Drover, Anne; Hayward, Mark; Valcour, James

    2015-01-01

    The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin…

  19. Can school-based oral health education and a sugar-free chewing gum program improve oral health?

    DEFF Research Database (Denmark)

    Peng, Bin; Petersen, Poul Erik; Bian, Zhuan

    2004-01-01

    The purpose of the study was to assess the outcome of school-based oral health education (OHE) and a sugar-free chewing gum program on the oral health status of children in terms of reduced caries increment and gingival bleeding over a period of 2 years. Nine primary schools randomly chosen from......-up. The overall drop-out rate was about 15%. Data on dental caries and gingival bleeding were collected by clinical examination. The results showed that the mean increment of DMFS in Group G was 42% lower than in groups E and C (P ... (P gingival bleeding scores were statistically significant among the three groups. Compared to Group C, the mean increment in bleeding scores of Group G was 71% lower (P

  20. Effect of a home-based simple yoga program in child-care workers: a randomized controlled trial.

    Science.gov (United States)

    Sakuma, Yumiko; Sasaki-Otomaru, Akiyo; Ishida, Sadayo; Kanoya, Yuka; Arakawa, Chiaki; Mochizuki, Yoshiko; Seiishi, Yukiko; Sato, Chifumi

    2012-08-01

    This study investigated the effect of a brief, simple, home-based yoga program on body pain and health status in child-care workers. This was a randomized, controlled trial comparing a home-based yoga group and a control group. The trial comprised 98 healthy female nursery school and kindergarten teachers. A DVD of a simple home-based yoga program was provided for a period of 2 weeks. The primary outcome measure was the reported change in body pain at 2 weeks (after intervention) and 4 weeks (follow-up). The secondary outcome measure was the 30-item General Health Questionnaire (GHQ30) score and physical function. The 67 yoga group participants reported improved menstrual pain at 4 weeks; menstrual pain was reduced from 57.0 ± 27.8 to 37.8 ± 26.7 in the yoga group, versus 52.4 ± 36.5 to 46.9 ± 32.1 in the control group (change from baseline in the yoga group versus change from baseline in the control group, -15.3 points; p=0.044). The total GHQ30 score and the GHQ subscale scores ("sleep disturbance" and "anxiety and dysphoria") improved significantly at 4 weeks in the yoga group, but not in the control group. In the good-adherence group, low back pain improved during the intervention (p=0.006) and follow-up (p=0.001) periods. Menstrual pain was also improved (p=0.044). No adverse events were observed. A home-based simple yoga program may improve the health status of child-care workers.

  1. Randomized Control Trials on Otago Exercise Program (OEP) to Reduce Falls Among Elderly Community Dwellers in Shahroud, Iran

    Science.gov (United States)

    Dadgari, Ali; Aizan Hamid, Tengku; Hakim, Mohammad Nazrul; Chaman, Reza; Mousavi, Seyed Abbas; Poh Hin, Lim; Dadvar, Leila

    2016-01-01

    Background Fall is a worldwide health problem among elderly people and a known leading cause of disabilities. Fall prevention programs have been implemented in various forms. The Otago exercise program (OEP) is one of the most recent home-base exercise training program. Objectives This study was conducted to examine the effectiveness of OEP to reduce falls among elderly people in Shahroud, IR Iran. Materials and Methods This randomised control trial was conducted among the elderly community dwellers in Shahroud city of the Semnan province, IR Iran, with experience of falls in the last 12 months. Subjects of the study (n = 317) were recruited from elderly senior citizens at public health centers. Block systematic random sampling was applied to categorize the subjects in experimental and control groups. The experimental group (n = 160) received OEP for six months and was compared with the control group (n = 157) who received general health training. This study was registered with the following ID, IRCT2014012016285N1. Results The findings of the study showed that OEP improved physical performance (Berg-Balance-Score with P > 0.025, and Timed-Up-Go-Test with P > 0.017) and functional capacity (Arm-Curl-Test with P > 0.00 and Chair-Stand-Test with P > 0.01). In addition, OEP significantly reduced the incidence of falls (P ≤ 0.00) among senior citizens in the experimental group. Discussion The OEP as a home-based exercise is effective for the reduction of the incidence of falls among senior citizens with a history of falls. The OEP can be recommended for elderly homebound people who do not have access to facilities. PMID:27478629

  2. The influence of worksite and employee variables on employee engagement in telephonic health coaching programs: a retrospective multivariate analysis.

    Science.gov (United States)

    Grossmeier, Jessica

    2013-01-01

    This study assessed 11 determinants of health coaching program participation. A cross-sectional study design used secondary data to assess the role of six employee-level and five worksite-level variables on telephone-based coaching enrollment, active participation, and completion. Data was provided by a national provider of worksite health promotion program services for employers. A random sample of 34,291 employees from 52 companies was selected for inclusion in the study. Survey-based measures included age, gender, job type, health risk status, tobacco risk, social support, financial incentives, comprehensive communications, senior leadership support, cultural support, and comprehensive program design. Gender-stratified multivariate logistic regression models were applied using backwards elimination procedures to yield parsimonious prediction models for each of the dependent variables. Employees were more likely to enroll in coaching programs if they were older, female, and in poorer health, and if they were at worksites with fewer environmental supports for health, clear financial incentives for participation in coaching, more comprehensive communications, and more comprehensive programs. Once employees were enrolled, program completion was greater among those who were older, did not use tobacco, worked at a company with strong communications, and had fewer environmental supports for health. Both worksite-level and employee-level factors have significant influences on health coaching engagement, and there are gender differences in the strength of these predictors.

  3. Effect evaluation of a self-management program for dutch workers with a chronic somatic disease: a randomized controlled trial

    NARCIS (Netherlands)

    Detaille, S.I.; Heerkens, Y.F.; Engels, J.A.; Gulden, J.W.J. van der; Dijk, F.J. van

    2013-01-01

    Purpose The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. Methods In a randomized

  4. Effectiveness of a Multilevel Workplace Health Promotion Program on Vitality, Health, and Work-Related Outcomes

    NARCIS (Netherlands)

    Hendriksen, I.J.M.; Snoijer, M.; Kok, B.P. de; Vlisteren, J. van; Hofstetter, H.

    2016-01-01

    Objective: Evaluation of the effectiveness of a workplace health promotion program on employees’ vitality, health, and work-related outcomes, and exploring the influence of organizational support and the supervisors’ role on these outcomes. Methods: The 5-month intervention included activities at

  5. Health Program Entrant's Math/Reading/Success Review.

    Science.gov (United States)

    Louisville Univ., KY. Dept. of Occupational and Career Education.

    A study was conducted to evaluate the effectiveness of the Tests of Adult Basic Education (TABE) in predicting success or lack of success in selected postsecondary health occupations programs. The predictor variables used in the project were the TABE reading and mathematics grade equivalent scores and the number of times each section of the TABE…

  6. Can object technology meet health care's programming needs?

    Science.gov (United States)

    McCormack, J

    1997-02-01

    Although object technology is just starting to make inroads in programming for health care applications, some observers predict it will drive information systems into the next century and beyond. Objects technology could play a major role in quicker development of the computer-based patient record and in easing the creation of links between systems.

  7. Targeting Obesity through Health Promotion Programs for School Staff

    Science.gov (United States)

    Herbert, Patrick C.; Lohrmann, David K.; Hall, Cougar

    2017-01-01

    Health promotion programs for school staff are an overlooked and under-utilized resource that can lead to reductions in overweight and obesity among teachers and other staff members if implemented properly. In addition to increasing the overall staff wellness, boosting morale, increasing productivity, improving academic achievement, providing…

  8. Targeting Obesity through Health Promotion Programs for School Staff

    Science.gov (United States)

    Herbert, Patrick C.; Lohrmann, David K.; Hall, Cougar

    2017-01-01

    Health promotion programs for school staff are an overlooked and under-utilized resource that can lead to reductions in overweight and obesity among teachers and other staff members if implemented properly. In addition to increasing the overall staff wellness, boosting morale, increasing productivity, improving academic achievement, providing…

  9. A Self-Insured Health Program: From Crisis to Opportunity

    Science.gov (United States)

    Steffes, Gary D.

    2008-01-01

    Moberly Area Community College faced a crisis in healthcare coverage that eventually lead to enhanced benefits, greater control, plan stability, and increased flexibility through a self-insured program. Presented here is how Moberly Area Community College overcame the health care coverage crisis and how other institutions can benefit from the…

  10. Prenatal Foundations: Fetal Programming of Health and Development

    Science.gov (United States)

    Davis, Elysia Poggi; Thompson, Ross A.

    2014-01-01

    The fetal programming and developmental origins of disease models suggest that experiences that occur before birth can have consequences for physical and mental health that persist across the lifespan. Development is more rapid during the prenatal period as compared to any other stage of life. This introductory article considers evidence that…

  11. Formulating Employability Skills for Graduates of Public Health Study Program

    Science.gov (United States)

    Qomariyah, Nurul; Savitri, Titi; Hadianto, Tridjoko; Claramita, Mora

    2016-01-01

    Employability skills (ES) are important for effective and successful individual participation in the workplace. The main aims of the research were to identify important ES needed by graduates of Public Health Study Program Universitas Ahmad Dahlan (PHSP UAD) and to assess the achievement of the ES development that has been carried out by PHSP UAD.…

  12. Monitoring of health care personnel employee and occupational health immunization program practices in the United States.

    Science.gov (United States)

    Carrico, Ruth M; Sorrells, Nikka; Westhusing, Kelly; Wiemken, Timothy

    2014-01-01

    Recent studies have identified concerns with various elements of health care personnel immunization programs, including the handling and management of the vaccine. The purpose of this study was to assess monitoring processes that support evaluation of the care of vaccines in health care settings. An 11-question survey instrument was developed for use in scripted telephone surveys. State health departments in all 50 states in the United States and the District of Columbia were the target audience for the surveys. Data from a total of 47 states were obtained and analyzed. No states reported an existing monitoring process for evaluation of health care personnel immunization programs in their states. Our assessment indicates that vaccine evaluation processes for health care facilities are rare to nonexistent in the United States. Identifying existing practice gaps and resultant opportunities for improvements may be an important safety initiative that protects patients and health care personnel.

  13. 77 FR 41190 - Office of Urban Indian Health Programs Funding Opportunity: Title V HIV/AIDS Program

    Science.gov (United States)

    2012-07-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Office of Urban Indian Health Programs Funding Opportunity: Title V HIV/AIDS Program AGENCY: Indian Health Service, HHS. ] ACTION: Notice: correction. SUMMARY: The...

  14. Comparative Effectiveness on Cognitive Asthma Outcomes of the SHARP Academic Asthma Health Education and Counseling Program and a Non-Academic Program.

    Science.gov (United States)

    Kintner, Eileen; Cook, Gwendolyn; Marti, C Nathan; Stoddard, Debbie; Gomes, Melissa; Harmon, Phyllis; Van Egeren, Laurie A

    2015-12-01

    Asthma morbidity and mortality is higher among older school-age children and early adolescents than other age groups across the lifespan. NIH recommended expanding asthma education to schools and community settings to meet cognitive outcomes that have an impact on morbidity and mortality. Guided by the acceptance of asthma model, an evidence-guided, comprehensive school-based academic health education and counseling program, Staying Healthy-Asthma Responsible & Prepared™ (SHARP), was developed. The program complements existing school curricula by integrating biology, psychology, and sociology content with related spelling, math, and reading and writing assignments. Feasibility, benefits, and efficacy have been established. We compared the effectiveness of SHARP to a non-academic program, Open Airways for Schools, in improving asthma knowledge and reasoning about symptom management. A two-group, cluster-randomized, single-blinded design was used with a sample of 205 students in grades 4-5 with asthma and their caregivers. Schools were matched prior to randomization. The unit of analysis was the student. Certified elementary school teachers delivered the programs during instructional time. Data were collected from student/caregiver dyads at baseline and at 1, 12, and 24 months after the intervention. In multilevel modeling, students enrolled in the academic SHARP program demonstrated significant (pasthma knowledge and reasoning over students enrolled in the non-academic program. Knowledge advantages were retained at 24 months. Findings support delivery in schools of the SHARP academic health education program for students with asthma.

  15. [Pedagogical training in stricto sensu graduate programs in public health].

    Science.gov (United States)

    Corrêa, Guilherme Torres; Ribeiro, Victoria Maria Brant

    2013-06-01

    The scope of this research is to discuss the relevance and need for pedagogical training of university lecturers in the Public Health field. The contention is that college teaching is a practice that requires specific training, since it is characterized by complex elements that transcend the mastery of given content. Considering stricto sensu graduate studies as an important stage in the training of future university lecturers, an attempt was made to identify and analyze the subjects and practices of pedagogical training in academic masters and doctorate programs in Public Health. To achieve the research aim, this work was based on Pierre Bourdieu's field theory and on Tomaz Tadeu da Silva's curriculum theory. Results indicate that the programs do not consider the aspect of teacher training as a major issue. With regard to the Public Health field approximately 61% of masters and 38% of doctorate programs have pedagogical training subjects/practices. Furthermore, there is a tendency for technical-instrumental training, which is in line with the history of the Public Health field. The conclusion is that there is a need to develop a culture that values college and graduate Public Health teaching, considering the complexity of pedagogical practice in all its dimensions.

  16. Pragmatic, Randomized Controlled Trials of the Girls on the Go! Program to Improve Self-Esteem in Girls.

    Science.gov (United States)

    Tirlea, Loredana; Truby, Helen; Haines, Terry P

    2016-03-01

    To test the effectiveness of an intervention delivered by health professionals outside the school environment to girls identified with issues such as poor body image, low self-esteem, low self-confidence, nonparticipation in sports, or being overweight or underweight. The study's design was a stepped-wedge randomized controlled trial to test the efficacy of an intervention on self-esteem, impairment induced by eating disorders, self-efficacy, body satisfaction, and dieting behaviors. The study took place at the community health center located in a culturally diverse area of Melbourne, Victoria, Australia. Participants were 122 primary and secondary school girls between 10 and 16 years of age. Girls on the Go! is a 10-week program designed to improve self-esteem, body image, and confidence, using an empowerment model that involved interactive and experiential learning approaches. Weekly themes included body image and self-esteem, safety and assertiveness, a healthy mind, physical activity, healthy eating, trust and confidence, and connections. Measurements were made using Rosenberg Self-Esteem Scale, clinical interview assessment, health self-efficacy (included mental health and physical health self-efficacy scales), body esteem scale, and the Dutch Eating Behavior Questionnaire for Children. A linear mixed model was used. The intervention led to a significant increase (p self-esteem and self-efficacy (mental and physical health self-efficacy subscales), for both primary and secondary school-aged participants and reduced dieting behaviors (secondary school participants). These gains were retained after 6 months of follow-up. This group-based, low-dose intervention, which, although targeting girls with a range of psychological issues and including both overweight and underweight participants, is a successful means of improving self-esteem among girls from diverse cultural backgrounds. © The Author(s) 2016.

  17. Ethical and managerial considerations regarding state physician health programs.

    Science.gov (United States)

    Boyd, J Wesley; Knight, John R

    2012-12-01

    Many physicians are referred to state physician health programs (PHPs) for evaluation, monitoring, and treatment of mental health and substance use disorders. Most PHPs are "diversion" or "safe haven" programs, meaning that physicians who suffer from alcohol or drug problems can have their case diverted to the PHP in lieu of being reported to the state licensing board. If the physician agrees to cooperate with the PHP and adhere to any recommendations it might make, the physician can avoid disciplinary action and remain in practice. These programs are therefore quite powerful and yet, to our knowledge, there has not been any systematic scrutiny of the ethical and management issues that arise in standard PHP practice. Given our 20 years of service as associate directors of one state PHP we analyze and evaluate the standard operating procedure of many PHPs and offer ethical critique as well as suggestions for improvement.

  18. Tailored Interactive Multimedia Computer Programs to Reduce Health Disparities: Opportunities and Challenges

    Science.gov (United States)

    Jerant, Anthony; Sohler, Nancy; Fiscella, Kevin; Franks, Becca; Franks, Peter

    2010-01-01

    Objective To review the theory and research evidence suggesting that tailored interactive multimedia computer programs (IMCPs) aimed at optimizing patient health behaviors could lessen socio-demographic health disparities. Methods Selective critical review of research regarding IMCPs tailored to psychological mediators of behavior and their effects on health behavior and outcomes among socio-demographically disadvantaged patients. Results Tailored IMCPs can address patient factors (e.g. language barriers, low self-efficacy) and buffer provider (e.g. cognitive bias) and health system (e.g. office visit time constraints) factors that contribute to poor provider-patient communication and, thereby, suboptimal health behaviors. Research indicates disadvantaged individuals' interactions with providers are disproportionately affected by such factors, and that their behaviors respond favorably to tailored information, thus suggesting tailored IMCPs could mitigate disparities. However, no randomized controlled trials (RCTs) have examined this question. The optimal design and deployment of tailored IMCPs for disadvantaged patients also requires further study. Conclusion Preliminary research suggests tailored IMCPs have the potential to reduce health disparities. RCTs designed expressly to examine this issue are warranted. Practice Implications Many socio-demographic health disparities exist, and there is a dearth of proven disparity-reducing interventions. Thus, if tailored IMCPs were shown to lessen disparities, the public health implications would be considerable. PMID:21146950

  19. An international randomized study of a home-based self-management program for severe COPD: the COMET

    Directory of Open Access Journals (Sweden)

    Bourbeau J

    2016-06-01

    Full Text Available Jean Bourbeau,1 Pere Casan,2 Silvia Tognella,3 Peter Haidl,4 Joëlle B Texereau,5,6 Romain Kessler7 On behalf of the COMET investigators 1Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, McGill University, Montreal, QC, Canada; 2Hospital Universitario Central de Asturias, Facultad de Medicina, Oviedo, Spain; 3Lung Department, Ospedale Orlandi, Bussolengo VR, Italy; 4Krankenhaus Kloster Grafschaft, Schmallenberg, Germany; 5Air Liquide Healthcare, Medical Research and Development, Jouy-en-Josas, 6Assistance Publique-Hôpitaux de Paris, Service de Physiologie Clinique, Hôpital Cochin, Paris, 7Department of Pulmonary Medicine, Translational Medicine Federation of Strasbourg, University Hospital of Strasbourg, Strasbourg, France Introduction: Most hospitalizations and costs related to COPD are due to exacerbations and insufficient disease management. The COPD patient Management European Trial (COMET is investigating a home-based multicomponent COPD self-management program designed to reduce exacerbations and hospital admissions.Design: Multicenter parallel randomized controlled, open-label superiority trial.Setting: Thirty-three hospitals in four European countries.Participants: A total of 345 patients with Global initiative for chronic Obstructive Lung Disease III/IV COPD.Intervention: The program includes extensive patient coaching by health care professionals to improve self-management (eg, develop skills to better manage their disease, an e-health platform for reporting frequent health status updates, rapid intervention when necessary, and oxygen therapy monitoring. Comparator is the usual management as per the center’s routine practice.Main outcome measures: Yearly number of hospital days for acute care, exacerbation number, quality of life, deaths, and costs. Keywords: COPD, disease management, exacerbations, hospitalization, home care, clinical trial

  20. Ethical review of health promotion program evaluation proposals.

    Science.gov (United States)

    Thurston, Wilfreda E; Vollman, Ardene Robinson; Burgess, Michael M

    2003-01-01

    Some policies state that program evaluation falls within the domain of administrative research that does not require review by an ethics review board. We propose that some health promotion program evaluations include at least one element of research and can be distinguished from quality assurance. Although American and Canadian evaluation societies provide important guidelines and standards for evaluation practitioners, processes for accountability to the public are provided by research ethics boards. The field of health promotion is, by its nature, replete with challenges to existing research ethics boards. Given the dearth of published literature on the ethics of health promotion evaluation or practice, the field could benefit from the open debate that reviews of proposals would encourage.

  1. Effects of the Web Behavior Change Program for Activity and Multimodal Pain Rehabilitation: Randomized Controlled Trial

    Science.gov (United States)

    Michaelson, Peter; Gard, Gunvor; Eriksson, Margareta K

    2016-01-01

    Background Web-based interventions with a focus on behavior change have been used for pain management, but studies of Web-based interventions integrated in clinical practice are lacking. To emphasize the development of cognitive skills and behavior, and to increase activity and self-care in rehabilitation, the Web Behavior Change Program for Activity (Web-BCPA) was developed and added to multimodal pain rehabilitation (MMR). Objective The objective of our study was to evaluate the effects of MMR in combination with the Web-BCPA compared with MMR among persons with persistent musculoskeletal pain in primary health care on pain intensity, self-efficacy, and copying, as part of a larger collection of data. Web-BCPA adherence and feasibility, as well as treatment satisfaction, were also investigated. Methods A total of 109 participants, mean age 43 (SD 11) years, with persistent pain in the back, neck, shoulder, and/or generalized pain were recruited to a randomized controlled trial with two intervention arms: (1) MMR+WEB (n=60) and (2) MMR (n=49). Participants in the MMR+WEB group self-guided through the eight modules of the Web-BCPA: pain, activity, behavior, stress and thoughts, sleep and negative thoughts, communication and self-esteem, solutions, and maintenance and progress. Data were collected with a questionnaire at baseline and at 4 and 12 months. Outcome measures were pain intensity (Visual Analog Scale), self-efficacy to control pain and to control other symptoms (Arthritis Self-Efficacy Scale), general self-efficacy (General Self-Efficacy Scale), and coping (two-item Coping Strategies Questionnaire; CSQ). Web-BCPA adherence was measured as minutes spent in the program. Satisfaction and Web-BCPA feasibility were assessed by a set of items. Results Of 109 participants, 99 received the allocated intervention (MMR+WEB: n=55; MMR: n=44); 88 of 99 (82%) completed the baseline and follow-up questionnaires. Intention-to-treat analyses were performed with a sample

  2. An assessment of health behavior peer effects in Peking University dormitories: a randomized cluster-assignment design for interference.

    Directory of Open Access Journals (Sweden)

    Changzheng Yuan

    Full Text Available BACKGROUND: Relatively little is known about the peer influence in health behaviors within university dormitory rooms. Moreover, in China, the problem of unhealthy behaviors among university students has not yet been sufficiently recognized. We thus investigated health behavior peer influence in Peking University dormitories utilizing a randomized cluster-assignment design. METHODS: STUDY DESIGN: Cross-sectional in-dormitory survey. STUDY POPULATION: Current students from Peking University Health Science Center from April to June, 2009. MEASUREMENT: Self-reported questionnaire on health behaviors: physical activity (including bicycling, dietary intake and tobacco use. RESULTS: Use of bicycle, moderate-intensity exercise, frequency of sweet food and soybean milk intake, frequency of roasted/baked/toasted food intake were behaviors significantly or marginally significantly affected by peer influence. CONCLUSION: Health behavior peer effects exist within dormitory rooms among university students. This could provide guidance on room assignment, or inform intervention programs. Examining these may demand attention from university administrators and policy makers.

  3. Integrating occupational health protection and health promotion: theory and program application.

    Science.gov (United States)

    Blix, A

    1999-04-01

    1. The worksite offers an excellent setting to focus on both health protection and health promotion. Collaboration between health professionals concerned with health protection and health promotion would achieve common goals of risk reduction related to job risks and life risks. 2. Workers who experience "double jeopardy" because they are exposed to job risks and life risks would benefit most. 3. Benefits of integration include lower health risks, joint responsibility to promote health and safety shared between management and workers, and cost effectiveness. 4. The social ecological model is useful in developing an integrated program as it is multidimensional, interdisciplinary, and includes the dynamic interplay between the environment and personal factors impacting the health outcome.

  4. Early Evaluation Findings From a Federally Funded Training Program: The Public Health Associate Program.

    Science.gov (United States)

    Sobelson, Robyn K; Young, Andrea C; Wigington, Corinne J; Duncan, Heather

    The Centers for Disease Control and Prevention (CDC) created the Public Health Associate Program (PHAP) to establish a continuous source of public health professionals who can deliver frontline services at the federal, state, tribal, local, and territorial levels. The article describes preliminary evaluation findings for PHAP. The evaluation's primary purposes are to assess the quality and effectiveness of PHAP, determine its value and impact, and provide information to continuously improve the program. Because the evaluation is both formative and summative and focuses on aggregate outputs and outcomes of PHAP, the methodology is complex and builds over time as different cohorts cycle into and out of the program. Results presented are outcomes of various Web-based surveys and reporting systems. Four PHAP cohorts, consisting of 579 individuals, participated in 1 or more of the evaluation activities described in this article. The majority of participants report satisfaction with their PHAP experiences, and 74% of recent graduates indicate they are continuing their careers or education in public health immediately after program completion. Seventy-eight percent of recent PHAP graduates who accept a job in public health are employed by the federal government. One year post-PHAP, 74% of alumni report that PHAP has been influential in their careers. CDC's investment in PHAP has increased the capacity and capabilities of the public health workforce. Results presented are early indicators of program quality, effectiveness, and impact. Today's public health workers are asked to do more with less, in the face of a dynamic array of complex public health challenges. PHAP offers public health agencies assistance in tackling these losses and challenges.

  5. The Importance of Cash in Conditional Cash Transfer Programs for Child Health, Growth and Development:

    Science.gov (United States)

    Fernald, Lia C. H.; Gertler, Paul J.; Neufeld, Lynnette M.

    2009-01-01

    Background Many governments around the world have implemented conditional cash transfer (CCT) programs with the goal of improving options for poor families through interventions in health, nutrition and education. Families enrolled in CCT programs receive cash in exchange for complying with “conditionalities” – preventive health requirements and nutrition supplementation, education and monitoring designed to improve health outcomes and promote positive behavior change. A great challenge in evaluating the effectiveness of CCT programs has been disaggregating the effects of the cash transfer component from that of the conditionalities. Methods In an intervention that began in 1998 in Mexico, low-income communities (n=506) were randomly assigned to be enrolled in a CCT program (Oportunidades, formerly Progresa) immediately or 18 months later. In 2003, children (n=3793), aged 24–72 months who had been enrolled in the program their entire lives, were assessed for a wide variety of outcomes. The analyses reported here separated out the association of the cash transfer component of Oportunidades with several outcomes in children from the program conditionalities, while controlling for a wide range of covariates including many measures of household socio-economic status. Findings An increase in the cash transfer to the household was associated with higher height-for-age z-score and hemoglobin concentration, lower prevalence of stunting, and lower prevalence of overweight. Children in families whose households received a greater quantity of cash also performed better on a scale of motor development (McCarthy Test of Children’s Abilities), three scales of cognitive development (sub-scales of the Woodcock-Muñoz, including working memory), and receptive language (Test de Vocabulario en Imágenes Peabody). Interpretation The results suggest that the cash transfer component of Oportunidades is associated with better outcomes in child health and development. PMID

  6. Effects of a weight management program on body composition and metabolic parameters in overweight children: a randomized controlled trial.

    Science.gov (United States)

    Savoye, Mary; Shaw, Melissa; Dziura, James; Tamborlane, William V; Rose, Paulina; Guandalini, Cindy; Goldberg-Gell, Rachel; Burgert, Tania S; Cali, Anna M G; Weiss, Ram; Caprio, Sonia

    2007-06-27

    Pediatric obesity has escalated to epidemic proportions, leading to an array of comorbidities, including type 2 diabetes in youth. Since most overweight children become overweight adults, this chronic condition results in serious metabolic complications by early adulthood. To curtail this major health issue, effective pediatric interventions are essential. To compare effects of a weight management program, Bright Bodies, on adiposity and metabolic complications of overweight children with a control group. One-year randomized controlled trial conducted May 2002-September 2005. Recruitment and follow-up conducted at Yale Pediatric Obesity Clinic in New Haven, Conn, and intervention at nearby school. Random sample of 209 overweight children (body mass index [BMI] >95th percentile for age and sex), ages 8 to 16 years of mixed ethnic groups were recruited. A total of 135 participants (60%) completed 6 months of study, 119 (53%) completed 12 months. Participants were randomly assigned to either a control or weight management group. The control group (n = 69) received traditional clinical weight management counseling every 6 months, and the weight management group (n = 105) received an intensive family-based program including exercise, nutrition, and behavior modification. Intervention occurred biweekly the first 6 months, bimonthly thereafter. The second randomization within the weight management group assigned participants (n = 35) to a structured meal plan approach (dieting), but this arm of the study was discontinued while enrollment was ongoing due to a high dropout rate. Change in weight, BMI, body fat, and homeostasis model assessment of insulin resistance (HOMA-IR) at 6 and 12 months. Six-month improvements were sustained at 12 months in weight management vs control, including changes in the following (mean [95% confidence interval]): weight (+0.3 kg [-1.4 to 2.0] vs +7.7 kg [5.3 to 10.0]); BMI (-1.7 [-2.3 to -1.1] vs +1.6 [0.8 to 2.3]); body fat (-3.7 kg [-5.4 to

  7. Global health education programming as a model for inter-institutional collaboration in interprofessional health education.

    Science.gov (United States)

    Peluso, Michael J; Hafler, Janet P; Sipsma, Heather; Cherlin, Emily

    2014-07-01

    While global health (GH) opportunities have expanded at schools of medicine, nursing, and public health, few examples of interprofessional approaches to GH education have been described. The elective GH program at our university serves as an important opportunity for high-quality interprofessional education. We undertook a qualitative study to examine the experience of student, faculty and administrative leaders of the program. We used content analysis to code responses and analyze data. Among the leadership, key themes fell within the categories of interprofessional education, student-faculty collaboration, professional development, and practical considerations for the development of such programs. The principles described could be considered by institutions seeking to develop meaningful partnerships in an effort to develop or refine interprofessional global health education programs.

  8. Randomized controlled trial evaluating the effectiveness of a web-based stress management program among community college students.

    Science.gov (United States)

    Frazier, Patricia; Meredith, Liza; Greer, Christiaan; Paulsen, Jacob A; Howard, Kelli; Dietz, Lindsey R; Qin, Kevin

    2015-01-01

    This study evaluated the effectiveness of a web-based stress management program among community college students that focused on increasing perceived control over stressful events. Students (N = 257) were randomly assigned to a Present Control Intervention or a Stress-information only comparison group. Primary outcomes were perceived stress and stress symptoms; secondary outcomes were depression and anxiety. Self-report measures were completed online at preintervention, postintervention, and three-week follow-up. Intervention effects were estimated using linear mixed models. Seventy-five percent of the sample (n = 194) completed the pretest and comprised the intent-to-treat sample. Participants in the intervention group reported significant increases in present control, and significant decreases in all four primary and secondary outcome measures from baseline to postintervention and follow-up. Within-group effect sizes were small to medium at postintervention (mean d = -.34) and follow-up (mean d = -.49). The mean between-group effect size on the four outcome measures was d = .35 at postintervention but d = .12 at follow-up, due to unexpected decreases in distress in the comparison group. Our online program is a cost-effective mental health program for college students. Limitations and future direction are discussed.

  9. Influence of school organizational characteristics on the outcomes of a school health promotion program.

    Science.gov (United States)

    Cullen, K W; Baranowski, T; Baranowski, J; Hebert, D; deMoor, C; Hearn, M D; Resnicow, K

    1999-11-01

    Researchers assessed the possible moderating effects of school organizational characteristics (school climate, school health, and job satisfaction) on outcomes of a teacher health behavior change program. Thirty-two public schools were matched and randomly assigned either to treatment or control conditions. Organizational, dietary, and physiologic data were collected from third to fifth grade teachers over three years. Treatment schools received a teacher wellness program for two years. Psychometrics of most organizational scales achieved acceptable levels of reliability. Mixed model analyses were conducted to test for moderating effects. Treatment schools with high organizational climate and health scores reported higher fruit and juice and vegetable consumption at Year 2 compared with intervention schools with low scores. Treatment schools with high job satisfaction scores reported higher fruit and juice and lower-fat food consumption at Year 3 compared with intervention schools with low scores. These measures may be used as a tool to assess the environment in which school health promotion programs are presented. Future interventions may need to be tailored to the organizational characteristics of schools.

  10. Australia’s National Health Programs: An Ontological Mapping

    Directory of Open Access Journals (Sweden)

    Arkalgud Ramaprasad

    2016-11-01

    Full Text Available Australia has a large number of health program initiatives whose comprehensive assessment will help refine and redefine priorities by highlighting areas of emphasis, under-emphasis, and non-emphasis. The objectives of our research are to: (a systematically map all the programs onto an ontological framework, and (b systemically analyse their relative emphases at different levels of granularity. We mapped all the health program initiatives onto an ontology with five dimensions, namely: (a Policy-scope, (b Policy-focus, (c Outcomes, (d Type of care, and (e Population served. Each dimension is expanded into a taxonomy of its constituent elements. Each combination of elements from the five dimensions is a possible policy initiative component. There are 30,030 possible components encapsulated in the ontology. It includes, for example: (a National financial policies on accessibility of preventive care for family, and (b Local-urban regulatory policies on cost of palliative care for individual-aged. Four of the authors mapped all of Australia’s health programs and initiatives on to the ontology. Visualizations of the data are used to highlight the relative emphases in the program initiatives. The dominant emphasis of the program initiatives is: [National] [educational, personnel-physician, information] policies on [accessibility, quality] of [preventive, wellness] care for the [community]. However, although (a information is emphasized technology is not; and (b accessibility and quality are emphasized cost, satisfaction, and quality are not. The ontology and the results of the mapping can help systematically reassess and redirect the relative emphases of the programs and initiatives from a systemic perspective.

  11. A salutogenic program to enhance sense of coherence and quality of life for older people in the community: A feasibility randomized controlled trial and process evaluation.

    Science.gov (United States)

    Tan, Khoon Kiat; Chan, Sally Wai-Chi; Wang, Wenru; Vehviläinen-Julkunen, Katri

    2016-01-01

    To determine the feasibility of a salutogenesis-based self-care program on quality of life, sense of coherence, activation and resilience among older community dwellers. This is a feasibility randomized controlled trial. Sixty-four older community-dwellers were recruited from a Singapore senior activity center and randomly assigned to intervention and control groups. The intervention group attended a 12-week Resource Enhancement and Activation Program. The outcomes were assessed with the Chinese versions of World Health Organization Quality of Life Scale, Sense of Coherence, Patient Activation Measure, and Connor-Davidson Resilience Scale. Process evaluation was conducted using focus groups with the intervention group. At the end of the program, the intervention group showed significant improvement in the Sense of Coherence scale and the psychological subscale of the WHO Quality of Life scale compared with the control group. Three themes emerged from the process evaluation: participation in the program, reflection on the experience, and improving the experience. A salutogenic self-care approach could be a potential health promotion strategy for older people. With improved sense of coherence and psychological aspect of quality of life, older people's self-care ability may improve, leading to better health and better quality of life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Learning professional ethics: Student experiences in a health mentor program.

    Science.gov (United States)

    Langlois, Sylvia; Lymer, Erin

    2016-01-01

    The use of patient centred approaches to healthcare education is evolving, yet the effectiveness of these approaches in relation to professional ethics education is not well understood. The aim of this study was to explore the experiences and learning of health profession students engaged in an ethics module as part of a Health Mentor Program at the University of Toronto. Students were assigned to interprofessional groups representing seven professional programs and matched with a health mentor. The health mentors, individuals living with chronic health conditions, shared their experiences of the healthcare system through 90 minute semi-structured interviews with the students. Following the interviews, students completed self-reflective papers and engaged in facilitated asynchronous online discussions. Thematic analysis of reflections and discussions was used to uncover pertaining to student experiences and learning regarding professional ethics. Five major themes emerged from the data: (1) Patient autonomy and expertise in care; (2) ethical complexity and its inevitable reality in the clinical practice setting; (3) patient advocacy as an essential component of day-to-day practice; (4) qualities of remarkable clinicians that informed personal ideals for future practice; (5) patients' perspectives on clinician error and how they enabled suggestions for improving future practice. The findings of a study in one university context suggest that engagement with the health mentor narratives facilitated students' critical reflection related to their understanding of the principles of healthcare ethics.

  13. Allied health graduate program - supporting the transition from student to professional in an interdisciplinary program.

    Science.gov (United States)

    Smith, Robyn A; Pilling, Samantha

    2007-06-01

    The transition from student to professional is challenging. Training programs provide discipline specific skills but do not adequately develop the interprofessional, team focused and work ready clinicians needed for the current workplace. In Australia, a formal graduate year is common in nursing; however, structured programs to support the student to professional transition are uncommon in allied health. This paper reports on the first year of an innovative program designed to address this gap. Fourteen new graduates at Northern Health in Melbourne, Australia from the disciplines of occupational therapy, physical education, physiotherapy, podiatry, social work and speech pathology participated in twelve, 2-hour sessions over a ten-month period during their first year of professional practice. These facilitated sessions aimed to foster reflective practice, peer support, to develop professional characteristics and provide an interdisciplinary forum for sharing experiences and learning. The paper outlines graduates and facilitators experience, together with the impacts for the health service.

  14. Credit with Health Education in Benin: A Cluster Randomized Trial Examining Impacts on Knowledge and Behavior.

    Science.gov (United States)

    Karlan, Dean; Thuysbaert, Bram; Gray, Bobbi

    2017-02-08

    We evaluate whether health education integrated into microcredit lending groups reduces health risks by improving health knowledge and self-reported behaviors among urban and rural borrowers in eastern Benin. In 2007, we randomly assigned 138 villages in the Plateau region of Benin to one of four variations of a group liability credit product, varying lending groups' gender composition and/or inclusion of health education using a 2 × 2 design. Women in villages receiving health education, regardless of gender composition of the groups, showed improved knowledge of malaria and of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), but not of childhood illness danger signs. No significant changes in health behavior were observed except an increase in HIV/AIDS prevention behavior, a result predominantly driven by an increase in respondents' self-reported ability to procure a condom, likely an indicator of increased perceived access rather than improved preventative behavior. Women in villages assigned to mixed-gender groups had significantly lower levels of social capital, compared with villages assigned to female-only groups. This suggests there may be an important trade-off to consider for interventions seeking improved health outcomes and social capital through provision of services to mixed-gender groups. Although bundling health education with microcredit can expand health education coverage and lower service-delivery costs, the approach may not be sufficient to improve health behaviors. © The American Society of Tropical Medicine and Hygiene.

  15. ADEA/AAL Institute for Allied Health Educators: Program Evaluation.

    Science.gov (United States)

    Gadbury-Amyot, Cynthia C; Overman, Pamela R; Grzesikowski, Tami; Tucker-Lively, Felicia; Weinstein, George; Haden, N Karl

    2015-05-01

    Revised accreditation standards for dental and dental hygiene education programs have increased emphasis on faculty development that can improve teaching and learning, foster curricular change including use of teaching and learning technologies, and enhance retention and satisfaction of faculty. The American Dental Education Association (ADEA) and Academy for Academic Leadership (AAL) established the Institute for Allied Health Educators (IAHE) in 2007 to address faculty development needs for allied dental and allied health educators. In 2009, it was transitioned to an online program, which resulted in increased enrollment and diversity of participants. After seven years, a comprehensive program evaluation was warranted. The authors developed an online questionnaire based on Kirkpatrick's four-level model of training evaluation; for this study, levels one (satisfaction), two (knowledge and skill acquisition), and three (behavior change) were examined. Of the 400 program participants invited to take part in the study, a 38% response rate was achieved, with the majority indicating full-time faculty status. Nearly all (95-97%) of the respondents agreed or strongly agreed the program contributed to their teaching effectiveness, and 88-96% agreed or strongly agreed it enhanced their knowledge of educational concepts and strategies. In addition, 83% agreed or strongly agreed the program helped them develop new skills and confidence with technology, with 69% agreeing or strongly agreeing that it helped them incorporate technology into their own educational setting. Nearly 90% were highly positive or positive in their overall assessment of the program; 95% indicated they would recommend it to a colleague; and 80% agreed or strongly agreed they had discussed what they learned with faculty colleagues at their home institutions who had not attended the program. Positive findings from this evaluation provide evidence that the IAHE has been able to meet its goals.

  16. The HIKCUPS trial: a multi-site randomized controlled trial of a combined physical activity skill-development and dietary modification program in overweight and obese children

    Directory of Open Access Journals (Sweden)

    Warren Janet M

    2007-01-01

    Full Text Available Abstract Background Childhood obesity is one of the most pressing health issues of our time. Key health organizations have recommended research be conducted on the effectiveness of well-designed interventions to combat childhood obesity that can be translated into a variety of settings. This paper describes the design and methods used in the Hunter Illawarra Kids Challenge Using Parent Support (HIKCUPS trial, an ongoing multi-site randomized controlled trial, in overweight/obese children comparing the efficacy of three interventions: 1 a parent-centered dietary modification program; 2 a child-centered physical activity skill-development program; and 3 a program combining both 1 and 2 above. Methods/Design Each intervention consists of three components: i 10-weekly face-to-face group sessions; ii a weekly homework component, completed between each face-to-face session and iii three telephone calls at monthly intervals following completion of the 10-week program. Details of the programs' methodological aspects of recruitment, randomization and statistical analyses are described here a priori. Discussion Importantly this paper describes how HIKCUPS addresses some of the short falls in the current literature pertaining to the efficacy of child obesity interventions. The HIKCUPS trial is funded by the National Medical Research Council, Australia.

  17. Community-based senior health promotion program using a collaborative practice model: the Escalante Health Partnerships.

    Science.gov (United States)

    Nuñez, Diane E; Armbruster, Charlotte; Phillips, Wayne T; Gale, Betty J

    2003-01-01

    Recent research demonstrates that, although the risk of disease and disability clearly increases with age, poor health need not be an inevitable consequence of aging. A healthy lifestyle is more influential than genetic factors in assisting older adults avoid the decline and deterioration traditionally associated with aging. Many effective strategies for reducing disease and disability are widely underused. The Escalante Health Partnerships is a community-based, nurse-managed health promotion and chronic disease care management program for community-residing older adults. The program base supports a multidisciplinary, collaborative practice model, which has responded to the health needs of members of a community at high risk of having or developing chronic conditions. Preliminary comparisons of the health status of program participants with national norms demonstrate that these seniors report better general health, performance of roles, and social functioning, with the strongest correlations occurring between general health and vitality and between general health and role-physical. In addition, these participants have 4.2 doctor visits per year, in comparison with 7.1 office visits for a national comparison group and 1.6 hospital days per year, in comparison with 2.1 hospital days in the same referenced population. This collaborative partnership is a model that can be replicated cost-effectively in other communities.

  18. When is informed consent required in cluster randomized trials in health research?

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    Boruch Robert

    2011-09-01

    Full Text Available Abstract This article is part of a series of papers examining ethical issues in cluster randomized trials (CRTs in health research. In the introductory paper in this series, we set out six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation. This paper addresses the second of the questions posed, namely, from whom, when, and how must informed consent be obtained in CRTs in health research? The ethical principle of respect for persons implies that researchers are generally obligated to obtain the informed consent of research subjects. Aspects of CRT design, including cluster randomization, cluster level interventions, and cluster size, present challenges to obtaining informed consent. Here we address five questions related to consent and CRTs: How can a study proceed if informed consent is not possible? Is consent to randomization always required? What information must be disclosed to potential subjects if their cluster has already been randomized? Is passive consent a valid substitute for informed consent? Do health professionals have a moral obligation to participate as subjects in CRTs designed to improve professional practice? We set out a framework based on the moral foundations of informed consent and international regulatory provisions to address each of these questions. First, when informed consent is not possible, a study may proceed if a research ethics committee is satisfied that conditions for a waiver of consent are satisfied. Second, informed consent to randomization may not be required if it is not possible to approach subjects at the time of randomization. Third, when potential subjects are approached after cluster randomization, they must be provided with a detailed description of the interventions in the trial arm to which their cluster has been randomized; detailed information on interventions in other trial arms need not be provided. Fourth, while passive consent may serve a

  19. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sumeet R Patil

    2014-08-01

    Full Text Available Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs, defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth.We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009, and revisited households 21 months later (February-April 2011 after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention, decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control. However, the intervention did not improve child health

  20. Effectiveness of a Multi-Component Intervention for Overweight and Obese Children (Nereu Program): A Randomized Controlled Trial

    National Research Council Canada - National Science Library

    Serra-Paya, Noemi; Ensenyat, Assumpta; Castro-Viñuales, Iván; Real, Jordi; Sinfreu-Bergués, Xènia; Zapata, Amalia; Mur, Jose María; Galindo-Ortego, Gisela; Solé-Mir, Eduard; Teixido, Concepció

    2015-01-01

    .... The 8-month study recruited 113 children aged 6 to 12 years with overweight/obesity. Before recruitment, eligible participants were randomly allocated to an intensive, family-based multi-component behavioural intervention (Nereu Program group...

  1. Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial

    NARCIS (Netherlands)

    Bakker, T.J.; Duivenvoorden, H.J.; Lee, J. van der; Olde Rikkert, M.G.M.; Beekman, A.T.; Ribbe, M.W.

    2011-01-01

    OBJECTIVE: To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). DESIGN: Randomized controlled trial. SETTIN

  2. [The position of nephrology in regional health programs in Italy].

    Science.gov (United States)

    Susi, Alessandra

    2010-01-01

    Regional health policies are acquiring remarkable importance in the allocation of healthcare resources, both human and financial. The importance of playing a prominent role in national and regional policy-making for healthcare professionals derives from the need to render the interventions of health policy more suitable to different territories. A review of all official regional healthcare plans approved in Italy until February 2009 has been carried out with the aim of recording the level of inclusion of nephrology in regional healthcare programming. The attention to kidney diseases has been delineated according to six levels of relevance: (i) the mere inclusion of nephrology in the plan, (ii) the level of priority of nephrology among other areas of intervention, (iii) the presence of new dedicated programs, (iv) the reinforcement of ongoing programs, (v) the allocation of specific resources, and (vi) the existence of nephrology networks. Nephrology does not turn out to be one of the priorities of intervention within the regional frameworks, with the exception of some regions which were found to be particularly sensitive to issues of outpatient care. Ad hoc measures for (i) the allocation of resources, (ii) the activation and (iii) the reinforcement of specific networks or programs were documented in a few cases. Nephrology is still too scarcely included in regional programming, considering the prevalence of chronic kidney disease in Italy. It is necessary that regional representatives of the discipline participate in healthcare planning to guarantee essential qualitative levels of healthcare for chronic kidney disease.

  3. The effects of behavioral modification based on client center program to health behaviors among obese university students.

    Science.gov (United States)

    Intarakamhang, Ungsinun; Malarat, Anan

    2013-10-08

    The objectives of this research were to examine the effectiveness of Health Behavioral Modification based on the Client Center Program (HBMCCP) and to study behavioral change in relation to self - efficacy, self- regulation, self-care behaviors and body weight. The sample was 59 undergraduate students, who were selected by cluster random sampling. 29 participated in the HBMCCP for 8 weeks, and were followed up 4 weeks after the program, and 30 students in the control group. Data was collected 3 times, before, immediately after and 4 weeks after the program, by 6 scale - questionnaires which had high reliability of Cronbach's alpha-coefficient between .81 to.94. The stratified variables were psycho-social variables, being a positive attitude towards health behavior and social support. Data were analyzed by MANOVA and ANCOVA. Results showed that 1) Obese students in the experimental group with HBMCCP had self - efficacy, self- regulation and self-care behavior at immediately after and 4 weeks later program significantly higher scores than before the program (pbehavior scores at immediately after and 4 weeks after the program significantly higher than obese students in the control group (p=0.009) and significantly lower body weights than obese students in the control group (p=0.026), and 3) No three - way interaction among positive attitude towards health behavior, social support and the program was found, although there was a two- way interaction between positive attitude towards health behavior and the program (p=0.001) and effect size=0.272.

  4. Teaching emotional intelligence to intensive care unit nurses and their general health: a randomized clinical trial.

    Science.gov (United States)

    Sharif, F; Rezaie, S; Keshavarzi, S; Mansoori, P; Ghadakpoor, S

    2013-07-01

    Emotion and how people manage it is an important part of personality that would immensely affect their health. Investigations showed that emotional intelligence is significantly related to and can predict psychological health. To determine the effect of teaching emotional intelligence to intensive care unit nurses on their general health. This randomized clinical trial (registered as IRCT201208022812N9) was conducted on 52 of 200 in intensive care unit nurses affiliated to Shiraz University of Medical Sciences. They were recruited through purposeful convenience sampling and then randomly categorized into two groups. The intervention group members were trained in emotional intelligence. Bar-on emotional intelligence and Goldberg's general health questionnaires were administered to each participant before, immediately after, and one month after the intervention. While the mean score of general health for the intervention group decreased from 25.4 before the intervention, to 18.1 immediately after the intervention and to 14.6 one month later, for the control group, it increased from 22.0, to 24.2 and to 26.5, respectively (pTeaching emotional intelligence improved the general health of intensive care unit nurses.

  5. Teaching Emotional Intelligence to Intensive Care Unit Nurses and their General Health: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    F Sharif

    2013-07-01

    Full Text Available Background: Emotion and how people manage it is an important part of personality that would immensely affect their health. Investigations showed that emotional intelligence is significantly related to and can predict psychological health. Objective: To determine the effect of teaching emotional intelligence to intensive care unit nurses on their general health. Methods: This randomized clinical trial (registered as IRCT201208022812N9 was conducted on 52 of 200 in intensive care unit nurses affiliated to Shiraz University of Medical Sciences. They were recruited through purposeful convenience sampling and then randomly categorized into two groups. The intervention group members were trained in emotional intelligence. Bar-on emotional intelligence and Goldberg's general health questionnaires were administered to each participant before, immediately after, and one month after the intervention. Results: While the mean score of general health for the intervention group decreased from 25.4 before the intervention, to 18.1 immediately after the intervention and to 14.6 one month later, for the control group, it increased from 22.0, to 24.2 and to 26.5, respectively (p<0.001. Conclusion: Teaching emotional intelligence improved the general health of intensive care unit nurses.

  6. Effects of an Integrated Stress Management Program (ISMP) for Psychologically Distressed Students: A Randomized Controlled Trial.

    Science.gov (United States)

    Kim, Sunah; Lee, Hyangkyu; Kim, Hyunlye; Noh, Dabok; Lee, Hyunhwa

    2016-07-01

    This study aimed to evaluate the effects of an integrated stress management program (ISMP) on college life stress, stress coping, psychological distress, and cortisol among male college students. Out of 137 initially enrolled students, 99 participants were identified as distressed subjects and randomly assigned to either the ISMP or control group. Ultimately, 84 participants (43: experimental, 41: control) completed pretest-posttest. The experimental group received eight 2-hr sessions over 4 weeks. Stress and psychological distress decreased significantly, whereas stress coping and cortisol did not improve significantly. Further studies with longer follow-up periods and physiological interventions are required. © 2015 Wiley Periodicals, Inc.

  7. 78 FR 40152 - World Trade Center Health Program Scientific/Technical Advisory Committee; Nominations of Candidates

    Science.gov (United States)

    2013-07-03

    ... (WTC) Health Program Scientific/Technical Advisory Committee (STAC). Title I of the James Zadroga 9/11... Health Service Act (PHS Act) by adding Title XXXIII establishing the WTC Health Program within HHS (Title... established the WTC Health Program Scientific/Technical Advisory Committee (STAC). The STAC is governed by the...

  8. 76 FR 9233 - Children's Health Insurance Program (CHIP); Allotment Methodology and States' Fiscal Years 2009...

    Science.gov (United States)

    2011-02-17

    ... the Children's Health Insurance Program (CHIP), as amended by the Children's Health Insurance Program.... SUPPLEMENTARY INFORMATION: I. Background A. The Children's Health Insurance Program Title XXI of the Social... Commonwealths and Territories to initiate and expand health insurance coverage to uninsured, low-income children...

  9. 77 FR 42417 - Federal Employees Health Benefits Program Coverage for Certain Firefighters

    Science.gov (United States)

    2012-07-19

    ... 3206-AM66 Federal Employees Health Benefits Program Coverage for Certain Firefighters AGENCY: Office of... (OPM) is issuing an interim final rule to amend the Federal Employees Health Benefits Program (FEHB... health insurance coverage under the Federal Employees Health Benefits (FEHB) program to...

  10. 78 FR 2413 - Office of Urban Indian Health Programs; Announcement Type: Meeting Notice

    Science.gov (United States)

    2013-01-11

    ... HUMAN SERVICES Indian Health Service Office of Urban Indian Health Programs; Announcement Type: Meeting...-policy-on-conferring-with-urban-indian-organizations . Information about the Urban Indian health program... Wolfe, Director, IHS Office of Urban Indian Health Programs. Phone: (301) 443-4680. Email:...

  11. A Randomized Controlled Trial Evaluation of an After-School Prosocial Behavior Program in an Area of Socioeconomic Disadvantage

    Science.gov (United States)

    O'Hare, Liam; Biggart, Andy; Kerr, Karen; Connolly, Paul

    2015-01-01

    A randomized controlled trial was used to evaluate the effects of a prosocial behavior after-school program called Mate-Tricks for 9- and 10-year-old children and their parents living in an area of significant socioeconomic disadvantage. The children were randomly assigned to an intervention (n = 220) or a control group (n = 198). Children were…

  12. The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.

    Science.gov (United States)

    Albaladejo, Celia; Kovacs, Francisco M; Royuela, Ana; del Pino, Rafael; Zamora, Javier

    2010-03-01

    Cluster randomized clinical trial. To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care. There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care. Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded. During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points). The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those

  13. [Basic family health program in Magdalena Medio y Bajo].

    Science.gov (United States)

    Murad, R

    1992-12-01

    The Program of Information, Education, and Services for Basic Family Health Care in Magdalena Medio and Bajo was designed to increase knowledge and use of contraception and to improve basic health practices and nutrition in the region, which includes municipios belonging to 9 different departments and a total population of 1,720,000. Poverty levels in the area are high. During the 1st year of the project, which was underway from February 1988-May 1991, home visits were made to inform each family about basic family health, to weigh and measure children under 5 not receiving health care elsewhere, and to refer families to the nearest health services. Talks were presented to small groups on family planning, intestinal parasites, sexually transmitted diseases, nutrition, vaccination, cancer prevention, malaria, acute diarrhea, and acute respiratory infection. Community workshops were presented in the 2nd year. Community distribution posts were created for contraceptive and other health product distribution. Information and communication materials from PROFAMILIA were used, and other materials were specially designed for the project by the Foundation for Development of Health Education in Colombia. PROFAMILIA's system of service statistics was used for quantitative evaluation of the information and education activities and sales of contraceptives, antiparasitics, and oral rehydration packets of each instructor. In the 3 years of the program, 89.086 cycles of pills, 398,772 condoms, 29,080 vaginal tablets, 209.791 antiparasitics, and 49,305 oral rehydration packets were sold. 9295 talks were presented to 143,227 residents of the region. 22,000 children were enrolled in the growth monitoring program, and almost 40,000 women were referred for prenatal care and cytology. The instructors gave 900 talks to distributors of contraceptives, antiparasitics, and oral rehydration packets. Surveys of women aged 15-49 residing in the municipios covered by the project were conducted

  14. Digital Citizenship and Health Promotion Programs: The Power of Knowing.

    Science.gov (United States)

    Hicks, Elaine R

    2016-11-03

    Patterns of Internet access and use among disadvantaged subgroups of Americans reveal that not all disparities are the same, a distinction crucial for appropriate public policies and health promotion program planning. In their book, Digital Citizenship: The Internet, Society, and Participation, authors Karen Mossberger, Caroline Tolbert, and Ramona McNeal deconstructed national opinion surveys and used multivariate methods of data analysis to demonstrate the impact of exclusion from online society economically, socially, and politically among disadvantaged Americans. © 2016 Society for Public Health Education.

  15. The evolution of Banner health's case management program.

    Science.gov (United States)

    Stutz, Linda

    2013-01-01

    The evolution of case management programs continues as health care systems adapt to the requirements and provisions under the Patient Protection and Affordable Care Act. One such provision establishes a new category of health care provider-the accountable care organization. These organizations provide a form of coordinated health care delivery. The successful integration of an accountable care organization, along with a better coordinated, higher quality case management care model, will provide better access to health care, improved care transitions and safety for the patients, and lower costs to the health system. Acute-care hospitals; ambulatory care centers; and primary care physician practices. A successful implementation of this type of case management model requires systematic changes to technological and organizational structures. The stewards of the case management model must be proactive in garnering and maintaining executive and financial support. y designing an electronic documentation system with one work flow and a standard set of data definitions, health systems will be able to provide standardization and reduce variations of care. This type of standardization creates a central database for easy reporting and decision making.• Achieved successes, associated with improved clinical outcomes, can translate into considerable reductions in the controllable expenses for a health system.

  16. Effects of donor proliferation in development aid for health on health program performance: A conceptual framework.

    Science.gov (United States)

    Pallas, Sarah Wood; Ruger, Jennifer Prah

    2017-02-01

    Development aid for health increased dramatically during the past two decades, raising concerns about inefficiency and lack of coherence among the growing number of global health donors. However, we lack a framework for how donor proliferation affects health program performance to inform theory-based evaluation of aid effectiveness policies. A review of academic and gray literature was conducted. Data were extracted from the literature sample on study design and evidence for hypothesized effects of donor proliferation on health program performance, which were iteratively grouped into categories and mapped into a new conceptual framework. In the framework, increases in the number of donors are hypothesized to increase inter-donor competition, transaction costs, donor poaching of recipient staff, recipient control over aid, and donor fragmentation, and to decrease donors' sense of accountability for overall development outcomes. There is mixed evidence on whether donor proliferation increases or decreases aid volume. These primary effects in turn affect donor innovation, information hoarding, and aid disbursement volatility, as well as recipient country health budget levels, human resource capacity, and corruption, and the determinants of health program performance. The net effect of donor proliferation on health will vary depending on the magnitude of the framework's competing effects in specific country settings. The conceptual framework provides a foundation for improving design of aid effectiveness practices to mitigate negative effects from donor proliferation while preserving its potential benefits.

  17. Effects of lifestyle education program for type 2 diabetes patients in clinics: study design of a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Kobayashi Itsuro

    2010-11-01

    Full Text Available Abstract Background The number of patients with type 2 diabetes is drastically increasing worldwide. It is a serious health problem in Japan as well. Lifestyle interventions can reduce progression from impaired glucose tolerance to type 2 diabetes, and glycemic control has been shown to improve postprandial plasma glucose levels. Moreover, several studies have suggested that continuous interventions (combined diet and exercise can improve the plasma glucose level and reduce dosage of hypoglycemic agents. Although many interventional studies of lifestyle education for persons with diabetes in hospitals have been reported, only a few have been clinic-based studies employing an evidence-based lifestyle education program. This article describes the design of a cluster randomized controlled trial of the effectiveness of lifestyle education for patients with type 2 diabetes in clinics by registered dietitians. Methods/Design In Japan, general practitioners generally have their own medical clinics to provide medical care for outpatients in the community, including those with type 2 diabetes. With the collaboration of such general practitioners, the study patients were enrolled in the present study. Twenty general practitioners were randomly allocated to each provide patients for entry into either an intervention group (10 or a control group (10. In total, 200 participants will be included in the study. The intervention group will receive intensive education on lifestyle improvement related to type 2 diabetes by registered dietitians in clinics. Lifestyle education will be conducted several times during the study period. The control group will receive information on dietary intake and standard advice on glycemic control by registered dietitians. The primary endpoint is the change from the baseline value of HbA1c at 6 months. Data on health behavior and related issues will be gathered continuously over a 6-month period. Discussion This is the first study

  18. Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program

    Directory of Open Access Journals (Sweden)

    Hewitt J

    2014-02-01

    Full Text Available Jennifer Hewitt,1 Kathryn M Refshauge,1 Stephen Goodall,2 Timothy Henwood,3 Lindy Clemson1 1Faculty of Health Sciences, University of Sydney, 2Centre for Health Economic Research and Evaluation, University of Technology, Sydney, NSW, 3University of Queensland/Blue Care Research and Practice Development Centre, The University of Queensland, Brisbane, QLD, Australia Introduction: Falls are common among older adults. It is reported that approximately 60% of residents of aged care facilities fall each year. This is a major cause of morbidity and mortality, and a significant burden for health care providers and the health system. Among community dwelling older adults, exercise appears to be an effective countermeasure, but data are limited and inconsistent among studies in residents of aged care communities. This trial has been designed to evaluate whether the SUNBEAM program (Strength and Balance Exercise in Aged Care reduces falls in residents of aged care facilities. Research question: Is the program more effective and cost-effective than usual care for the prevention of falls? Design: Single-blinded, two group, cluster randomized trial. Participants and setting: 300 residents, living in 20 aged care facilities. Intervention: Progressive resistance and balance training under the guidance of a physiotherapist for 6 months, then facility-guided maintenance training for 6 months. Control: Usual care. Measurements: Number of falls, number of fallers, quality of life, mobility, balance, fear of falling, cognitive well-being, resource use, and cost-effectiveness. Measurements will be taken at baseline, 6 months, and 12 months. Analysis: The number of falls will be analyzed using a Poisson mixed model. A logistic mixed model will be used to analyze the number of residents who fall during the study period. Intention-to-treat analysis will be used. Discussion: This study addresses a significant shortcoming in aged care research, and has potential to impact

  19. Implementing a prenatal oral health program through interprofessional collaboration.

    Science.gov (United States)

    Jackson, Jeffrey T; Quinonez, Rocio B; Kerns, Amanda K; Chuang, Alice; Eidson, R Scott; Boggess, Kim A; Weintraub, Jane A

    2015-03-01

    Interprofessional collaboration has become a critical component of accreditation standards in dentistry and medicine. This article reports on implementation in an academic setting of a prenatal oral health program (pOHP) that addresses coordinated care, accreditation standards, and new clinical practice guidelines. The pOHP is an educational intervention for third-year medical students, residents, and faculty members to deliver preventive oral health information and referral to a dental home for pregnant women. At the same time, senior dental students and faculty members are introduced to prenatal oral health principles and delivery of comprehensive oral health care to pregnant women. A systems-based approach was used to guide the pOHP implementation during the 2012-13 academic year. Participants were 96 third-year medical students (50% of the total in an obstetrics and gynecology clerkship) and all 81 fourth-year dental students. During that academic year, 126 dental referrals were made to the School of Dentistry, and 55 women presented for care, resulting in 50% (n=40) of dental students participating in the clinical experience and delivery of simple to complex oral health procedures. The prenatal period is a frequently missed opportunity to address oral health care. The pOHP is an interprofessional collaboration model designed to educate dental and medical providers and provide a system of referral for comprehensive clinical care of pregnant patients, including educating women about their oral health and that of their children. Such programs can help meet interprofessional accreditation standards and encourage implementation of practice guidelines.

  20. 1997 Operating plan for the Office of International Health Programs

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    One year ago, the Office of International Health Programs provided you with our 1996 Operating Plan, which defined our ideas and ideals for conducting business in 1996. We have again this year undertaken an intensive planning effort, first reviewing our accomplishments and shortcomings during 1996, and then developing plans and priorities for the upcoming year, taking into account input from customers and outside review panels, and ensuring that the demands on the office have been balanced with anticipated human, financial, and material resources.

  1. SHPPS 2006: School Health Policies and Programs Study--Foods and Beverages Sold Outside of the School Meals Programs

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of foods and beverages sold outside of the school meals program. (Contains 3 tables, 1 figure, and 2…

  2. Effect of an Intensive Outpatient Program to Augment Primary Care for High-Need Veterans Affairs Patients: A Randomized Clinical Trial.

    Science.gov (United States)

    Zulman, Donna M; Pal Chee, Christine; Ezeji-Okoye, Stephen C; Shaw, Jonathan G; Holmes, Tyson H; Kahn, James S; Asch, Steven M

    2017-02-01

    Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Randomized clinical trial at a single VA facility. Among 583 eligible high-need outpatients whose health care costs or hospitalization risk were in the top 5% for the facility, 150 were randomly selected for ImPACT; the remaining 433 received standard PACT care. The ImPACT multidisciplinary team addressed health care needs and quality of life through comprehensive patient assessments, intensive case management, care coordination, and social and recreational services. Primary difference-in-difference analyses examined changes in health care costs and acute and extended care utilization over a 16-month baseline and 17-month follow-up period. Secondary analyses estimated the intervention's effect on ImPACT participants (using randomization as an instrument) and for patients with key sociodemographic and clinical characteristics. ImPACT participants' satisfaction and activation levels were assessed using responses to quality improvement surveys administered at baseline and 6 months. Of 140 patients assigned to ImPACT, 96 (69%) engaged in the program (mean [SD] age, 68.3 [14.2] years; 89 [93%] male; mean [SD] number of chronic conditions, 10 [4]; 62 [65%] had a mental health diagnosis; 21 [22%] had a history of homelessness). After accounting for program costs, adjusted person-level monthly health care expenditures decreased similarly for ImPACT and PACT patients (difference-in-difference [SE] -$101 [$623]), as did acute and extended care utilization rates. Among respondents to the ImPACT follow-up survey (n = 54 [56% response rate]), 52

  3. [Impact of a disaster preparedness training program on health staff].

    Science.gov (United States)

    Parra Cotanda, Cristina; Rebordosa Martínez, Mónica; Trenchs Sainz de la Maza, Victoria; Luaces Cubells, Carles

    2016-09-01

    The aim of this study is to evaluate the effectiveness of a disaster preparedness training program in a Paediatric Emergency Department (PED). A quasi-experimental study was conducted using an anonymous questionnaire that was distributed to health care providers of a PED in a tertiary paediatric hospital. The questions concerned the disaster plan (DP), including theoretical and practical aspects. Questionnaires were distributed and completed in January 2014 (period 1) and November 2014 (period 2). The disaster training program includes theoretical and practical sessions. A total of 110 questionnaires were collected in period 1, and 80 in period 2. Almost three-quarters (71.3%) of PED staff attended the theoretical sessions, and 43.8% attended the practical sessions. The application of this training program significantly improved knowledge about the DP, but no improvement was observed in the practical questions. PED staff felt more prepared to face a disaster after the training program (15.5% vs. 41.8%, P<.001). The training program improved some knowledge about the disaster plan, but it has not improved responses in practical situations, which may be due to the low attendance at practical sessions and the time between the training program and the questionnaires. Copyright © 2015 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Mental health first aid training for high school teachers: a cluster randomized trial

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2010-06-01

    Full Text Available Abstract Background Mental disorders often have their first onset during adolescence. For this reason, high school teachers are in a good position to provide initial assistance to students who are developing mental health problems. To improve the skills of teachers in this area, a Mental Health First Aid training course was modified to be suitable for high school teachers and evaluated in a cluster randomized trial. Methods The trial was carried out with teachers in South Australian high schools. Teachers at 7 schools received training and those at another 7 were wait-listed for future training. The effects of the training on teachers were evaluated using questionnaires pre- and post-training and at 6 months follow-up. The questionnaires assessed mental health knowledge, stigmatizing attitudes, confidence in providing help to others, help actually provided, school policy and procedures, and teacher mental health. The indirect effects on students were evaluated using questionnaires at pre-training and at follow-up which assessed any mental health help and information received from school staff, and also the mental health of the student. Results The training increased teachers' knowledge, changed beliefs about treatment to be more like those of mental health professionals, reduced some aspects of stigma, and increased confidence in providing help to students and colleagues. There was an indirect effect on students, who reported receiving more mental health information from school staff. Most of the changes found were sustained 6 months after training. However, no effects were found on teachers' individual support towards students with mental health problems or on student mental health. Conclusions Mental Health First Aid training has positive effects on teachers' mental health knowledge, attitudes, confidence and some aspects of their behaviour. Trial registration ACTRN12608000561381

  5. [RELEVANCE OF A PROGRAM BALANCE IN HEALTH-RELATED QUALITY OF LIFE OF OBESE ELDERLY WOMEN].

    Science.gov (United States)

    Prieto, Jose Antonio; Del Valle, Miguel; Nistal, Paloma; Méndez, David; Barcala-Furelos, Roberto; Abelairas-Gómez, Cristian

    2015-12-01

    the objective of this study was to analyze the effects of a specific intervention program of strength and balance in the quality of life in obese women elderly. a total of 56 obese women elderly (average 67.2 +/- 2.1 age) were randomized into control group (28) and experimental (28). The experimental group carried out an exercise program based on balance and lower body strength, for 24 weeks. Balance and strength was measured before and after the intervention. Similarly, the perception health-related quality of life (HRQOL) was determined using SF-36 . the experimental group showed a significant improvement in all tests. In the test of the chair was observed an increase of 28.3% after the program (P balance with closed eyes (P balance produces positive changes in the stability of a sample of obese women elderly, significantly improving HRQOL in all dimensions, emphasizing physical health and social function and mental health mental components. Are opened new avenues for greater welfare of obese women elderly. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  6. Behavioral Health and Performance Operations During the Space Shuttle Program

    Science.gov (United States)

    Beven, G.; Holland, A.; Moomaw, R.; Sipes, W.; Vander Ark, S.

    2011-01-01

    Prior to the Columbia STS 107 disaster in 2003, the Johnson Space Center s Behavioral Health and Performance Group (BHP) became involved in Space Shuttle Operations on an as needed basis, occasionally acting as a consultant and primarily addressing crew-crew personality conflicts. The BHP group also assisted with astronaut selection at every selection cycle beginning in 1991. Following STS 107, an event that spawned an increased need of behavioral health support to STS crew members and their dependents, BHP services to the Space Shuttle Program were enhanced beginning with the STS 114 Return to Flight mission in 2005. These services included the presence of BHP personnel at STS launches and landings for contingency support, a BHP briefing to the entire STS crew at L-11 months, a private preflight meeting with the STS Commander at L-9 months, and the presence of a BHP consultant at the L-1.5 month Family Support Office briefing to crew and family members. The later development of an annual behavioral health assessment of all active astronauts also augmented BHP s Space Shuttle Program specific services, allowing for private meetings with all STS crew members before and after each mission. The components of each facet of these BHP Space Shuttle Program support services will be presented, along with valuable lessons learned, and with recommendations for BHP involvement in future short duration space missions

  7. Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial.

    Science.gov (United States)

    Yalcin, Bektas Murat; Unal, Mustafa; Pirdal, Hasan; Karahan, Tevfik Fikret

    2014-01-01

    The purpose of this study was to investigate the effects of a cognitive behavioral therapy-oriented anger management and stress control program on smokers' quit rates. Of 2348 smokers, 350 were randomly allocated into study and control groups (n = 175 each). An individualized therapy cessation technique was selected for each participant (combination of behavioral counseling, nicotine replacement therapy, and/or pharmacotherapy). The participants in the control group attended a standard quit program, whereas the study group also received an additional 5-session (90 minutes each) cognitive behavioral therapy-oriented program aimed at improving their anger and stress coping skills. At the beginning of the study, both groups were asked to complete the Trait Anger Scale (TAS) of the State and Trait Anger Scale and the Self-Confident (SCS) and Hopeless (HS) subscales of the Stress Coping Styles Inventory; pretest smoking status of both groups and their coping skills were compared with each other as soon as the program ended (post-test results) and after 3 and 6 months (first and second follow-up tests). Although there was no difference between pretest scores on the TAS (P = .234), SCS (P = .130), and HS (P = .148) subscales, post-test results indicate that the study groups' TAS and HS scores decreased and SCS scores increased (P .05). The study group had a better quit level after 6 months compared with the control group (44% vs 27.4%; P anger management and stress control program was found to have a significant effect on cessation (odds ratio, 2.09; 95% confidence interval, 1.14-3.85). The anger and stress coping skills program may increase the success of quitting smoking. © Copyright 2014 by the American Board of Family Medicine.

  8. Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

    Science.gov (United States)

    Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

    2015-01-01

    Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (Pdevelopment indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. IRCT2014082013690N3 

  9. A prospective randomized study of the efficacy of "Turning Point," an inpatient violence intervention program.

    Science.gov (United States)

    Loveland-Jones, Catherine; Ferrer, Lucas; Charles, Scott; Ramsey, Frederick; van Zandt, Andrea; Volgraf, Jill; Santora, Thomas; Pathak, Abhijit; Dujon, Jay; Sjoholm, Lars; Rappold, Joseph; Goldberg, Amy

    2016-11-01

    From 2002 to 2011, there were more than 17,000 shootings in Philadelphia. "Turning Point," Temple University Hospital's inpatient violence intervention program, takes advantage of the teachable moment that occurs after violent injury. In addition to receiving traditional social work services, Turning Point patients watch their trauma bay resuscitation video and a movie about violence, meet with a gunshot wound survivor and an outpatient case manager, and also undergo psychiatric assessment. The purpose of this study was to determine the efficacy of Turning Point in changing attitudes toward guns and violence among victims of penetrating trauma. This prospective randomized study was conducted from January 2012 to January 2014. Patients who sustained a gunshot or stab wound were randomized to standard of care, which involved traditional social work services only, or Turning Point. The Attitudes Toward Guns and Violence Questionnaire was administered to assess attitude change. Analysis was performed with repeated-measures analysis of variance. A p violence. Turning Point is effective in changing attitudes toward guns and violence among victims of penetrating trauma. Longer follow-up is necessary to determine if this program can truly be a turning point in patients' lives. Therapeutic/care management study, level II.

  10. Knowledge of health information and services in a random sample of the population of Glasgow.

    Science.gov (United States)

    Moynihan, M; Jones, A K; Stewart, G T; Lucas, R W

    1980-01-01

    A RANDOM sample of adults in Glasgow was surveyed by trained interviewers to determine public knowledge on four topics chosen specifically for each of four age groups. The topics were: Welfare rights and services; Coronary Heart Disease (CHD) and individual action that can reduce risk; The dangers of smoking in pregnancy; and fluoride and its functions and the connections between good health and habitual behaviour.

  11. Evaluating an interdisciplinary undergraduate training program in health promotion research.

    Science.gov (United States)

    Misra, Shalini; Harvey, Richard H; Stokols, Daniel; Pine, Kathleen H; Fuqua, Juliana; Shokair, Said M; Whiteley, John M

    2009-04-01

    The University of California at Irvine Interdisciplinary Summer Undergraduate Research Experience (ID-SURE) program had three objectives: (1) designing an interdisciplinary health promotion training curriculum for undergraduate research fellows; (2) developing measures for evaluating and assessing program-related educational processes and products; and (3) comparing these educational process and product measures between groups of students who did or did not receive the training. A total of 101 students participated in the ID-SURE program during 2005, 2006, and 2007. A longitudinal research design was employed whereby students' interdisciplinary attitudes and behaviors were assessed at the beginning and end of the training program. The interdisciplinary and intellectual qualities of students' academic and research products were assessed at the conclusion of the training activities. In addition, ID-SURE participants' interdisciplinary attitudes, behaviors, and research products were compared to those of 70 participants in another fellowship program that did not have an interdisciplinary training component. Exposing undergraduate research fellows to the interdisciplinary curriculum led to increased participation in, and positive attitudes about, interdisciplinary classroom and laboratory activities. Products, such as the integrative and interdisciplinary quality of student research projects, showed no differences when compared to those of undergraduates who were not exposed to the interdisciplinary curriculum. However, undergraduates exposed to the training engaged in more interdisciplinary behaviors at the end of the program than students who were not trained in interdisciplinary research techniques. The findings from this study offer evidence for the efficacy of the ID-SURE program for training undergraduate students in transdisciplinary concepts, methods, and skills that are needed for effective scientific collaboration. Additionally, this study makes two important

  12. Health promotion and partnerships: collaboration of a community health management center, county health bureau, and university nursing program.

    Science.gov (United States)

    Huang, Chih-Ling

    2002-06-01

    Effective partnerships were established between a community health management center, a county health bureau and a university nursing program. A health fair was undertaken to heighten public health awareness through the collaboration of these various agencies. In this research, formative, process, and summative evaluations were conducted to determine the benefits of partnerships. Elements evaluated included the planning process, health fair relevancy, integration of community resources, participants satisfaction and knowledge acquisition, and partnership satisfaction. The samples of this study included (1) 529 adult participants who completed the on-site evaluation questionnaires; (2) 1,090 child participants who returned gift-reward cards; (3) 114 partners who gave written feedback on their satisfaction; and (4) 57 third-year and 16 fourth-year undergraduate nursing student participants. Data was collected from the evidence report of the Department of Health, the project proposal, activity protocols, meeting records, the project final report, students term papers, and questionnaires. The chief administrator of the County Health Bureau was very impressed with the creative exhibits in the fair and, therefore, invited a coalition to continue further workshops. Seventeen educational exhibits, two dance programs and two drama programs related to health issues were demonstrated in the fair. Resources from community organizations were successfully integrated and allocated. Community participants expressed satisfaction with the fair and anticipated similar activities in the future. Participants revealed more than 80% accuracy in health knowledge quizzes. The senior nursing students highlighted their interaction with the community, community health nurses, and health volunteers. Community-based health promotion and nursing education can be successfully connected when various disciplines and sectors form effective partnerships.

  13. Developing Built Environment Programs in Local Health Departments: Lessons Learned From a Nationwide Mentoring Program

    Science.gov (United States)

    Rube, Kate; Veatch, Maggie; Huang, Katy; Lent, Megan; Goldstein, Gail P.; Lee, Karen K.

    2014-01-01

    Local health departments (LHDs) have a key role to play in developing built environment policies and programs to encourage physical activity and combat obesity and related chronic diseases. However, information to guide LHDs’ effective engagement in this arena is lacking. During 2011–2012, the New York City Department of Health and Mental Hygiene (DOHMH) facilitated a built environment peer mentoring program for 14 LHDs nationwide. Program objectives included supporting LHDs in their efforts to achieve built environment goals, offering examples from DOHMH’s built environment work to guide LHDs, and building a healthy built environment learning network. We share lessons learned that can guide LHDs in developing successful healthy built environment agendas. PMID:24625166

  14. Wisconsin Healthy Birth Outcomes: minority health program challenges and contributions.

    Science.gov (United States)

    Cruz, Evelyn; Guhleman, Patricia; Onheiber, Patrice Mocny

    2008-11-01

    For at least 20 years, the probability that an infant born in Wisconsin would die during the first year of life has been approximately three times greater for infants born to African American women than for those born to White women. Over the same period of time, other states have made improvements in African American infant mortality, whereas Wisconsin's ranking has fallen to last place. Various state and local efforts have been made to address the issue; however, it is only in the last 2 to 3 years that Wisconsin's high rate of African American infant mortality has become an agreed-upon health priority. This article discusses the factors that have converged to bring African American infant mortality to the forefront of Wisconsin public health policy and programs. Particular attention is given to the role of Wisconsin's Minority Health Program in relation to public health leadership and coalition building. Key actions currently underway to implement effective, evidence-based solutions are also described.

  15. [Effectiveness of a stretching program on anxiety levels of workers in a logistic platform: a randomized controlled study].

    Science.gov (United States)

    Montero-Marín, Jesús; Asún, Sonia; Estrada-Marcén, Nerea; Romero, Rosario; Asún, Roberto

    2013-01-01

    To study the influence of a short programme of stretching exercises on anxiety levels of workers in a Spanish logistic company. A controlled clinical trial was carried out by means of an inter-subject design of random homogeneous blocks. Participants were assigned to the experimental group (n=67), treated with a programme of stretching exercises of 10-minute duration after working hours for a period of 3 months, or to the untreated control group (n=67). The primary result variable was anxiety, and the secondary variables were burnout syndrome, quality of life and flexibility. An analysis of covariance (ANCOVA) by intention to treat was performed on each of the result variables by controlling the baseline scores, the age and the practice of introjective activities outside the program, with the size effect calculated by means of the partial eta-squared value (η(2)). The results of the ANCOVA showed a moderate effect of the stretching exercise programme on the levels of anxiety (η(2)=0,06; P=.004). Other effects found were substantial for flexibility (η(2)=0,13; P<.001); moderately high for bodily pain (η(2)=0,08; P=.001), and moderate for vitality (η(2)=0,05; P=.016); mental health (η(2)=0,05; P=.017); general health (η(2)=0,04; P=.028) and exhaustion (η(2)=0,04; P=.025). The implementation of a short programme of stretching exercises in the work place was effective for reducing levels of anxiety, bodily pain and exhaustion, and for raising levels of vitality, mental health, general health and flexibility. This type of intervention could be seen as a low-cost strategy for improving the well-being of workers. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  16. A Randomized Control Trial to Investigate the Impact of the Lidcombe Program on Early Stuttering in German-Speaking Preschoolers

    Science.gov (United States)

    Lattermann, Christina; Euler, Harald A.; Neumann, Katrin

    2008-01-01

    In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both…

  17. Opening the Black Box: Intervention Fidelity in a Randomized Trial of a Preschool Teacher Professional Development Program

    Science.gov (United States)

    Mendive, Susana; Weiland, Christina; Yoshikawa, Hirokazu; Snow, Catherine

    2016-01-01

    "Un Buen Comienzo" [A Good Start] was a professional development program implemented with prekindergarten and kindergarten teachers in Chilean public schools serving low-income families. In a randomized trial, the program showed moderate to large impacts on classroom quality but no impacts on targeted child outcomes. To unpack these…

  18. Dissonance and Healthy Weight Eating Disorder Prevention Programs: Long-Term Effects from a Randomized Efficacy Trial

    Science.gov (United States)

    Stice, Eric; Marti, C. Nathan; Spoor, Sonja; Presnell, Katherine; Shaw, Heather

    2008-01-01

    Adolescent girls with body dissatisfaction (N = 481, SD = 1.4) were randomized to a dissonance-based thin-ideal internalization reduction program, healthy weight control program, expressive writing control condition, or assessment-only control condition. Dissonance participants showed significantly greater decreases in thin-ideal internalization,…

  19. A Randomized Controlled Trial of a Parent Training and Emotion Socialization Program for Families of Hyperactive Preschool-Aged Children

    Science.gov (United States)

    Herbert, Sharonne D.; Harvey, Elizabeth A.; Roberts, Jasmin L.; Wichowski, Kayla; Lugo-Candelas, Claudia I.

    2013-01-01

    The present study evaluated the effectiveness of a parent training and emotion socialization program designed specifically for hyperactive preschoolers. Participants were 31 preschool-aged children whose parents were randomly assigned to a parent training (PT) or waitlist (WL) control group. PT parents took part in a 14-week parenting program that…

  20. 76 FR 74076 - Notice of Random Assignment Study To Evaluate the YouthBuild Program; Final Notice

    Science.gov (United States)

    2011-11-30

    ... Employment and Training Administration Notice of Random Assignment Study To Evaluate the YouthBuild Program... Department of Labor (Department) will conduct an evaluation to provide rigorous, nationally-representative estimates of the net impacts of the YouthBuild program. The Department has determined that it is in...

  1. Long-term effects of 1-year maintenance training on physical functioning and health status in patients with COPD: A randomized controlled study

    DEFF Research Database (Denmark)

    Ringbaek, Thomas; Brondum, Eva; Martinez, Gerd;

    2010-01-01

    PURPOSE: To examine whether maintenance training (MT) for 1 year improved the long-term effects of a 7-week chronic obstructive pulmonary disease (COPD) rehabilitation program. METHODS: After a 7-week outpatient rehabilitation program, 96 patients with COPD were randomized to either an MT group (n...... study period. Primary effect parameters were Endurance Shuttle Walk Test (ESWT) time and health status (St. George's Respiratory Questionnaire, SGRQ). Secondary effect parameters were adherence to supervised training, dropout rates, and hospitalization. RESULTS: Compared with the control group, the MT...

  2. Randomized Trial of Social Rehabilitation and Integrated Health Care for Older People with Severe Mental Illness

    Science.gov (United States)

    Mueser, Kim T.; Pratt, Sarah I.; Bartels, Stephen J.; Swain, Karin; Forester, Brent; Cather, Corinne; Feldman, James

    2010-01-01

    Objective: The Helping Older People Experience Success (HOPES) program was developed to improve psychosocial functioning and reduce long-term medical burden in older people with severe mental illness (SMI) living in the community. HOPES includes 1 year of intensive skills training and health management, followed by a 1-year maintenance phase.…

  3. School Mental Health Services for the 21st Century: Lessons from the District of Columbia School Mental Health Program

    Science.gov (United States)

    Price, Olga Acosta; Lear, Julia Graham

    2008-01-01

    In January 2007, The Center for Health and Health Care in Schools at the George Washington University School of Public Health and Health Services was commissioned to assess operations of school mental health programs in Washington, D.C. and recommend future directions in practices, policies and systems development. While this guidance is directed…

  4. Effectiveness of a school-based physical activity injury prevention program: a cluster randomized controlled trial.

    Science.gov (United States)

    Collard, Dorine C M; Verhagen, Evert A L M; Chinapaw, Mai J M; Knol, Dirk L; van Mechelen, Willem

    2010-02-01

    To study the effects of a school-based injury prevention program on physical activity injury incidence and severity. Cluster randomized controlled trial performed from January 1, 2006, through July 31, 2007. Forty Dutch primary schools. A total of 2210 children (aged 10-12 years). Schools were randomized to receive either the regular curriculum or an intervention program that targeted physical activity injuries. Incidence and severity of physical activity injuries per 1000 hours of physical activity participation. A total of 100 injuries in the intervention group and 104 injuries in the control group were registered. Nonresponse at baseline or follow-up was minimal (8.7%). The Cox regression analyses adjusted for clustering showed a small nonsignificant intervention effect on total (HR, 0.81; 95% confidence interval [CI], 0.41-1.59), sports club (0.69; 0.28-1.68), and leisure time injuries (0.75; 0.36-1.55). However, physical activity appeared to be an effect modifier. In those who were less physically active, the intervention had a larger effect. The intervention reduced the total and leisure time injury incidence (HR, 0.47; 95% CI, 0.21-1.06; and 0.43; 0.16-1.14; respectively). Sports club injury incidence was significantly reduced (HR, 0.23; 95% CI, 0.07-0.75). We found a substantial and relevant reduction in physical activity injuries, especially in children in the low active group, because of the intervention. This school-based injury prevention program is promising, but future large-scale research is needed.

  5. A Cluster Randomized Controlled Trial of the MyFamilyPlan Online Preconception Health Education Tool.

    Science.gov (United States)

    Batra, Priya; Mangione, Carol M; Cheng, Eric; Steers, W Neil; Nguyen, Tina A; Bell, Douglas; Kuo, Alice A; Gregory, Kimberly D

    2017-01-01

    To evaluate whether exposure to MyFamilyPlan-a web-based preconception health education module-changes the proportion of women discussing reproductive health with providers at well-woman visits. Cluster randomized controlled trial. One hundred thirty participants per arm distributed among 34 clusters (physicians) required to detect a 20% change in the primary outcome. Urban academic medical center (California). Eligible women were 18 to 45 years old, were English speaking, were nonpregnant, were able to access the Internet, and had an upcoming well-woman visit. E-mail and phone recruitment between September 2015 and May 2016; 292 enrollees randomized. Intervention participants completed the MyFamilyPlan module online 7 to 10 days before a scheduled well-woman visit; control participants reviewed standard online preconception health education materials. The primary outcome was self-reported discussion of reproductive health with the physician at the well-woman visit. Self-reported secondary outcomes were folic acid use, contraceptive method initiation/change, and self-efficacy score. Multilevel multivariate logistic regression. After adjusting for covariates and cluster, exposure to MyFamilyPlan was the only variable significantly associated with an increase in the proportion of women discussing reproductive health with providers (odds ratio: 1.97, 95% confidence interval: 1.22-3.19). Prespecified secondary outcomes were unaffected. MyFamilyPlan exposure was associated with a significant increase in the proportion of women who reported discussing reproductive health with providers and may promote preconception health awareness; more work is needed to affect associated behaviors.

  6. 76 FR 38281 - Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated...

    Science.gov (United States)

    2011-06-29

    .... Federal Employees Health Benefits Program: New Premium Rating Method for Most Community Rated Plans... 3206-AM39 Federal Employees Health Benefits Program: New Premium Rating Method for Most Community...

  7. Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

    Data.gov (United States)

    Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

  8. Evaluation of Effectiveness of Integrated Intervention Program in Improving Drug Addicts' Psychological Health1

    Institute of Scientific and Technical Information of China (English)

    YA-QIONG YAN; YONG-YOU LIU; YUE-FENG ZENG; YI-WEI CUI; JI-WEI LEI; ZENG-ZHEN WANG

    2008-01-01

    Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center;evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts' psychological health.Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004,who satisfied the inclusion criteria.A non-randomized control-intervention study design was adopted.Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse.The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts' psychological health:before the intervention,the scores of Self-Rating Anxiety Scale(SAS),the positive and negative dimensionalities of Simple Coping Style Questionnaire(SCSQ)and Chinese Perceived Stress Scales(CPSS)had no significant differences between the intervention group and the control group.After the intervention,exccpt that the SCSQ's positive dimensionality in the intervention group was significantly higher than that in the control group,other indices in the intervention group were lower.Before and after the intervention.the psychological health level in both the groups was lower than that in the normal population;there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts' social mental factors.The integrated intervention program can alleviate anxiety and stress,reduce co-morbid mental disorders and effectively improve their coping style.In conclusion,the program can promote addicts' psychological health significantly.

  9. Team sponsors in community-based health leadership programs.

    Science.gov (United States)

    Patterson, Tracy Enright; Dinkin, Donna R; Champion, Heather

    2017-05-02

    Purpose The purpose of this article is to share the lessons learned about the role of team sponsors in action-learning teams as part of community-based health leadership development programs. Design/methodology/approach This case study uses program survey results from fellow participants, action learning coaches and team sponsors to understand the value of sponsors to the teams, the roles they most often filled and the challenges they faced as team sponsors. Findings The extent to which the sponsors were perceived as having contributed to the work of the action learning teams varied greatly from team to team. Most sponsors agreed that they were well informed about their role. The roles sponsors most frequently played were to provide the teams with input and support, serve as a liaison to the community and serve as a sounding board, motivator and cheerleader. The most common challenges or barriers team sponsors faced in this role were keeping engaged in the process, adjusting to the role and feeling disconnected from the program. Practical implications This work provides insights for program developers and community foundations who are interested in building the capacity for health leadership by linking community sponsors with emerging leaders engaged in an action learning experience. Originality/value This work begins to fill a gap in the literature. The role of team sponsors has been studied for single organization work teams but there is a void of understanding about the role of sponsors with multi-organizational teams working to improve health while also learning about leadership.

  10. Randomized and comparative study between two intra-hospital exercise programs for heart transplant patients

    Directory of Open Access Journals (Sweden)

    Tatiana Satie Kawauchi

    2013-09-01

    Full Text Available OBJECTIVE: To compare the effects of two physical therapy exercise in-hospital programs in pulmonary function and functional capacity of patients in the postoperative period of heart transplantation. METHODS: Twenty-two heart transplanted patients were randomized to the control group (CG, n=11 and training group (TG, n=11. The control group conducted the exercise program adopted as routine in the institution and the training group has had a protocol consisting of 10 stages, with incremental exercises: breathing exercises, resistance training, stretching and walking. The programs began on the first day after extubation and stretched until hospital discharge. Assessed pulmonary function, distance walked in six minutes walk test (6MWT and peripheral muscle strength by one repetition maximum test (1RM. RESULTS: Similar behavior was observed between the two groups treated, with statistically significant increases between the first and second test of the following variables: FVC (59% in CG and 35.2% in TG; MIP (8.6% in CG and 53.5% in TG, MEP (28.8% in CG and 40.7% in TG and 6MWT (44.5% in CG and 31.4% in TG. There was an increase of peripheral strength by 1RM test, over time, to the muscle groups of the elbow flexors, shoulder flexors, hip abductors and knee flexors. CONCLUSION: Heart transplant patients benefit from exercise programs in hospital, regardless of the program type applied. A new training proposal did not result in superiority compared to routine programme applied. Exercise protocols provided improves in ventilatory variables and functional capacity of this population.

  11. Encouraging Health Insurance for the Informal Sector: A Cluster Randomized Experiment in Vietnam.

    Science.gov (United States)

    Wagstaff, Adam; Nguyen, Ha Thi Hong; Dao, Huyen; Bales, Sarah

    2016-06-01

    Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. We report the results of a cluster randomized experiment, in which 3000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam's government-run scheme and the benefits of health insurance, a voucher entitling eligible household members to 25% off their annual premium, and both. At baseline, the four groups had similar enrollment rates (4%) and were balanced on plausible enrollment determinants. The interventions all had small and insignificant effects (around 1 percentage point or ppt). Among those reporting sickness in the 12 months prior to the baseline survey the subsidy-only intervention raised enrollment by 3.5 ppts (p = 0.08) while the combined intervention raised enrollment by 4.5 ppts (p = 0.02); however, the differences in the effect sizes between the sick and non-sick were just shy of being significant. Our results suggest that information campaigns and subsidies may have limited effects on voluntary health insurance enrollment in Vietnam and that such interventions might exacerbate adverse selection. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd.

  12. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

    Science.gov (United States)

    2012-01-01

    Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!') has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140) are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health) care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program starts (T1), and one week

  13. The effectiveness of a trauma-focused psycho-educational secondary prevention program for children exposed to interparental violence: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Overbeek Mathilde M

    2012-02-01

    Full Text Available Abstract Background Children who witness interparental violence are at a heightened risk for developing psychosocial, behavioral and cognitive problems, as well as posttraumatic stress symptoms. For these children the psycho-educational secondary prevention program 'En nu ik...!' ('It's my turn now!' has been developed. This program includes specific therapeutic factors focused on emotion awareness and expression, increasing feelings of emotional security, teaching specific coping strategies, developing a trauma narrative, improving parent-child interaction and psycho-education. The main study aim is to evaluate the effectiveness of the specific therapeutic factors in the program. A secondary objective is to study mediating and moderating factors. Methods/design This study is a prospective multicenter randomized controlled trial across cities in the Netherlands. Participants (N = 140 are referred to the secondary preventive intervention program by police, social work, women shelters and youth (mental health care. Children, aged 6-12 years, and their parents, who experienced interparental violence are randomly assigned to either the intervention program or the control program. The control program is comparable on nonspecific factors by offering positive attention, positive expectations, recreation, distraction, warmth and empathy of the therapist, and social support among group participants, in ways that are similar to the intervention program. Primary outcome measures are posttraumatic stress symptoms and emotional and behavioral problems of the child. Mediators tested are the ability to differentiate and express emotions, emotional security, coping strategies, feelings of guilt and parent-child interaction. Mental health of the parent, parenting stress, disturbances in parent-child attachment, duration and severity of the domestic violence and demographics are examined for their moderating effect. Data are collected one week before the program

  14. The Effectiveness of School-Based Nutritional Education Program among Obese Adolescents: A Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Supinya In-Iw

    2012-01-01

    Full Text Available The purpose of the study was to determine the change in body weight and body mass index (BMI, as well as diet behaviors at 4 months after intervention between obese adolescent girls who participated in the school-based nutritional education program, addressed by pediatrician, compared to those who attended regular nutritional class. Methods. 49 obese girls were recruited from a secondary school. Those, were randomized into 2 groups of intervention and control. The intensive interactive nutritional program was provided to the intervention group. Weight and height, dietary record and % fat consumption, as well as self-administered questionnaires on healthy diet attitudes were collected at baseline and 4-month follow-up, and then compared between two groups. Results. There was a statistically significant change of BMI in the intervention group by  kg/m2 ( compared to the control group ( kg/m2, but no significant change in calorie and % fat consumption between groups. The attitudes on healthy eating behaviors in the intervention group were shown improving significantly (. Conclusions. Interactive and intensive nutritional education program as shown in the study was one of the most successful school-based interventions for obese adolescents.

  15. Mobile health in China: a review of research and programs in medical care, health education, and public health.

    Science.gov (United States)

    Corpman, David W

    2013-01-01

    There are nearly 1 billion mobile phone subscribers in China. Health care providers, telecommunications companies, technology firms, and Chinese governmental organizations use existing mobile technology and social networks to improve patient-provider communication, promote health education and awareness, add efficiency to administrative practices, and enhance public health campaigns. This review of mobile health in China summarizes existing clinical research and public health text messaging campaigns while highlighting potential future areas of research and program implementation. Databases and search engines served as the primary means of gathering relevant resources. Included material largely consists of scientific articles and official reports that met predefined inclusion criteria. This review includes 10 reports of controlled studies that assessed the use of mobile technology in health care settings and 17 official reports of public health awareness campaigns that used text messaging. All source material was published between 2006 and 2011. The controlled studies suggested that mobile technology interventions significantly improved an array of health care outcomes. However, additional efforts are needed to refine mobile health research and better understand the applicability of mobile technology in China's health care settings. A vast potential exists for the expansion of mobile health in China, especially as costs decrease and increasingly sophisticated technology becomes more widespread.

  16. "EFFECTS OF A HEALTH EDUCATION PROGRAM ON BEHAVIOR, HBA1C AND HEALTH-RELATED QUALITY OF LIFE IN DIABETIC PATIENTS"

    OpenAIRE

    Aghamolaei, T; H.Eftekhar; Mohammad, K; M. Nakhjavani; Shojaeizadeh, D.; F. Ghofranipour; O. Safa

    2005-01-01

    Diabetes mellitus is a chronic disease of lifelong duration and its management requires a fundamental change in patient’s lifestyle. The aim of this study is to evaluate the efficacy of an interactive health education program on knowledge, behavior, HbA1c and health-related quality of life (HRQOL) of diabetic patients. Eighty patients were randomly selected and assigned to two groups, 40 to the intervention and 40 to the control group. All participants were followed for 4 months. At the initi...

  17. Promoting Fitness and Safety in Elementary Students: A Randomized Control Study of the Michigan Model for Health

    Science.gov (United States)

    O'Neill, James M.; Clark, Jeffrey K.; Jones, James A.

    2016-01-01

    Background: In elementary grades, comprehensive health education curricula have demonstrated effectiveness in addressing singular health issues. The Michigan Model for Health (MMH) was implemented and evaluated to determine its impact on nutrition, physical fitness, and safety knowledge and skills. Methods: Schools (N = 52) were randomly assigned…

  18. Context by treatment interactions as the primary object of study in cluster randomized controlled trials of population health interventions.

    Science.gov (United States)

    Fuller, Daniel; Potvin, Louise

    2012-06-01

    Cluster randomized controlled trials are increasingly used in population health intervention research. Through randomization, researchers attempt to isolate the treatment effect and remove all other effects, including any effects of social context. In many cases, the constant effect assumption cannot be satisfied in cluster randomized controlled trials. We argue that when studying population health interventions, the effective mechanism of intervention lies in the interaction between the treatment and social context. Researchers should be cognizant that attempts to remove the effect of social context using CRTC may fail. The interaction between the treatment and social context should be the primary object of study in population health intervention research.

  19. Applied Grant Writing Training for Future Health Communication Researchers: The Health Communication Scholars Program.

    Science.gov (United States)

    Mackert, Michael; Donovan, Erin E; Bernhardt, Jay M

    2017-02-01

    Health communication faculty face increasing expectations regarding their academic productivity, including the expectation to seek and secure external funding. Doctoral training in health communication that does not fully prepare students for the challenges of securing external funding is doing them a disservice that will make them less competitive for academic positions and less likely to succeed in the academic positions they assume. The purpose of this study is to share the evaluation of a program, the Health Communication Scholars Program (HCSP), designed to train future health communication researchers in the pursuit of external funding. The HCSP includes a grant-writing workshop, requires interdisciplinary graduate student teams to submit applications, and awards funding to top proposals. HCSP participants responding to an evaluation survey (N = 25) had overwhelmingly positive experiences; respondents felt the program provided great value, improved their writing skills, gave them skills to pursue funding in the future, and helped them secure tenure-track faculty positions. The results of this formal evaluation suggest the HCSP is an experience that builds crucial skills and prepares graduate students for the demands they will face as faculty. It is a relatively low-cost, replicable model that merits consideration and adoption at other institutions that hope to provide professional development for doctoral students interested in health communication.

  20. 76 FR 46684 - Medicaid and Children's Health Insurance Programs; Disallowance of Claims for FFP and Technical...

    Science.gov (United States)

    2011-08-03

    ...-AQ32 Medicaid and Children's Health Insurance Programs; Disallowance of Claims for FFP and Technical... within that time period; make conforming changes to the Medicaid and Children's Health Insurance Program... the Children's Health Insurance Program (CHIP) to jointly fund State efforts to initiate and expand...

  1. The Impact of Two Workplace-Based Health Risk Appraisal Interventions on Employee Lifestyle Parameters, Mental Health and Work Ability: Results of a Randomized Controlled Trial

    Science.gov (United States)

    Addley, K.; Boyd, S.; Kerr, R.; McQuillan, P.; Houdmont, J.; McCrory, M.

    2014-01-01

    Health risk appraisals (HRA) are a common type of workplace health promotion programme offered by American employers. In the United Kingdom, evidence of their effectiveness for promoting health behaviour change remains inconclusive. This randomized controlled trial examined the effects of two HRA interventions on lifestyle parameters, mental…

  2. mHealth Physical Activity Intervention: A Randomized Pilot Study in Physically Inactive Pregnant Women.

    Science.gov (United States)

    Choi, JiWon; Lee, Ji Hyeon; Vittinghoff, Eric; Fukuoka, Yoshimi

    2016-05-01

    Physical inactivity is prevalent in pregnant women, and innovative strategies to promote physical activity are strongly needed. The purpose of the study was to test a 12-week mobile health (mHealth) physical activity intervention for feasibility and potential efficacy. Participants were recruited between December 2012 and February 2014 using diverse recruitment methods. Thirty pregnant women between 10 and 20 weeks of gestation were randomized to an intervention (mobile phone app plus Fitbit) or a control (Fitbit) group. Both conditions targeted gradual increases in physical activity. The mHealth intervention included daily messages and a mobile phone activity diary with automated feedback and self-monitoring systems. On monthly average, 4 women were screened for initial eligibility by telephone and 2.5 were randomized. Intervention participants had a 1096 ± 1898 step increase in daily steps compared to an increase of 259 ± 1604 steps in control participants at 12 weeks. The change between groups in weekly mean steps per day during the 12-week study period was not statistically significant (p = 0.38). The intervention group reported lower perceived barrier to being active, lack of energy, than the control group at 12-week visit (p = 0.02). The rates of responding to daily messages and using the daily diary through the mobile app declined during the 12 week study period. It was difficult to recruit and randomize inactive women who wanted to increase physical activity during pregnancy. Pregnant women who were motivated to increase physical activity might find using mobile technologies in assessing and promoting PA acceptable. Possible reasons for the non-significant treatment effect of the mHealth intervention on physical activity are discussed. Public awareness of safety and benefits of physical activity during pregnancy should be promoted. Clinicaltrials.Gov Identifier NCT01461707.

  3. Lay health educators increase colorectal cancer screening among Hmong Americans: A cluster randomized controlled trial.

    Science.gov (United States)

    Tong, Elisa K; Nguyen, Tung T; Lo, Penny; Stewart, Susan L; Gildengorin, Ginny L; Tsoh, Janice Y; Jo, Angela M; Kagawa-Singer, Marjorie L; Sy, Angela U; Cuaresma, Charlene; Lam, Hy T; Wong, Ching; Tran, Mi T; Chen, Moon S

    2017-01-01

    Asian Americans have lower colorectal cancer (CRC) screening rates than non-Hispanic white individuals. Hmong Americans have limited socioeconomic resources and literacy. The current randomized controlled trial was conducted to determine whether bilingual/bicultural lay health educator (LHE) education could increase CRC screening among Hmong Americans. A cluster randomized controlled trial was conducted among Hmong Americans in Sacramento, California. LHEs and recruited participants were randomized to intervention or control groups. The intervention group received CRC education over 3 months delivered by an LHE. The control group received education regarding nutrition and physical activity delivered by a health educator. The outcomes were changes in self-reported ever-screening and up-to-date CRC screening after 6 months. All 329 participants were foreign-born with mostly no formal education, limited English proficiency, and no employment. The majority of the participants were insured and had a regular source of health care. The intervention group experienced greater changes after the intervention than the control group for ever-screening (P = .068) and being up-to-date with screening (Pscreening (adjusted odds ratio, 1.73; 95% confidence interval, 1.07-2.79) and being up-to-date with screening (adjusted odds ratio, 1.71; 95% confidence interval, 1.26-2.32). Individuals who had health insurance were found to have >4 times the odds of receiving screening, both ever-screening and up-to-date screening. A higher CRC knowledge score mediated the intervention effect for both screening outcomes. A culturally and linguistically appropriate educational intervention delivered by trained LHEs was found to increase CRC screening in an immigrant population with low levels of education, employment, English proficiency, and literacy. Cancer 2017;98-106. © 2016 American Cancer Society. © 2016 American Cancer Society.

  4. Effect of an office worksite-based yoga program on heart rate variability: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Chang Dennis

    2011-07-01

    Full Text Available Abstract Background Chronic work-related stress is a significant and independent risk factor for cardiovascular and metabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. Heart rate variability (HRV provides an estimate of parasympathetic and sympathetic autonomic control, and can serve as a marker of physiological stress. Hatha yoga is a physically demanding practice that can help to reduce stress; however, time constraints incurred by work and family life may limit participation. The purpose of the present study is to determine if a 10-week, worksite-based yoga program delivered during lunch hour can improve resting HRV and related physical and psychological parameters in sedentary office workers. Methods and design This is a parallel-arm RCT that will compare the outcomes of participants assigned to the experimental treatment group (yoga to those assigned to a no-treatment control group. Participants randomized to the experimental condition will engage in a 10-week yoga program delivered at their place of work. The yoga sessions will be group-based, prescribed three times per week during lunch hour, and will be led by an experienced yoga instructor. The program will involve teaching beginner students safely and progressively over 10 weeks a yoga sequence that incorporates asanas (poses and postures, vinyasa (exercises, pranayama (breathing control and meditation. The primary outcome of this study is the high frequency (HF spectral power component of HRV (measured in absolute units; i.e. ms2, a measure of parasympathetic autonomic control. Secondary outcomes include additional frequency and time domains of HRV, and measures of physical functioning and psychological health status. Measures will be collected prior to and following the intervention period, and at 6 months follow-up to determine the effect of intervention withdrawal. Discussion This study will determine the effect of worksite

  5. An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

    Science.gov (United States)

    Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

    2015-01-01

    To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

  6. Implicit theories and youth mental health problems: a random-effects meta-analysis.

    Science.gov (United States)

    Schleider, Jessica L; Abel, Madelaine R; Weisz, John R

    2015-02-01

    Compared to youths who believe that personal traits are malleable, those who believe that personal traits are fixed experience more academic and self-regulatory distress. Recently, studies have begun to explore relations between beliefs about the malleability of personal traits, or implicit theories, and youth mental health problems. We synthesized this emerging body of research in youths (ages 4-19) across 45 effect sizes from 17 research reports. Studies were included if they assessed youth mental health and implicit theories and did not manipulate implicit theory or affective/behavioral states prior to measuring these variables. Our random-effects meta-analysis using clustered data analysis techniques (i.e., effect sizes nested within samples) revealed that youths holding entity theories-the belief that personal traits are fixed-showed more pronounced mental health problems. This association between entity theories and mental health problems was evident across methodological factors and problem types (internalizing versus externalizing; psychopathology versus general distress). Limitations include the small number of eligible studies, insufficient data to test further demographic moderators, and few longitudinal studies on this topic. Overall, findings support the value of parsing the implicit theory-mental health link in youths. Implicit theories may prove to be promising targets for treatment and prevention of youth mental health problems.

  7. Health promotion and disease prevention: a look at demand management programs.

    Science.gov (United States)

    Fronstin, P

    1996-09-01

    This Issue Brief describes employers' efforts to contain health expenditures through demand management programs. These programs are designed to reduce utilization by focusing on disease prevention and health promotion. Demand management includes work site health promotion, wellness programs, and access management. Work site health promotion is a comprehensive approach to improving health and includes awareness, health education, behavioral change, and organizational health initiatives. Wellness programs usually include stress management, smoking cessation, weight management, back care, health screenings, nutrition education, work place safety, prenatal and well baby care, CPR and first aid classes, and employee assistance programs (EAPs). These programs are often viewed positively by workers and can have long-term benefits for employers above and beyond health care cost containment. Demand management can benefit employers by increasing productivity, employee retention, and employee morale and by reducing turnover, absenteeism, future medical claims, and ultimately expenditures on health care. Even though a growing number of employers are offering wellness programs, only 37 percent of full-time workers employed in medium and large private establishments were eligible for wellness programs by 1993. However, a recent survey found that 88 percent of major employers have introduced some form of health promotion, disease prevention, or early intervention initiative to encourage healthy lifestyles among their salaried employees. Distinctions must be drawn between short- and long-term strategies. Demand management can be thought of as a short-term strategy when the focus of the program is on creating more appropriate and efficient health care utilization. Disease prevention is characterized by longer-term health improvement objectives. Whether the purpose is to reduce utilization in the short term or in the long term, the ultimate goal remains the same: to reduce health

  8. Programming generality into a performance feedback writing intervention: A randomized controlled trial.

    Science.gov (United States)

    Hier, Bridget O; Eckert, Tanya L

    2016-06-01

    Substantial numbers of students in the United States are performing below grade-level expectations in core academic areas, and these deficits are most pronounced in the area of writing. Although performance feedback procedures have been shown to produce promising short-term improvements in elementary-aged students' writing skills, evidence of maintenance and generalization of these intervention effects is limited. The purpose of this study was to examine the immediate, generalized, and sustained effects of incorporating multiple exemplar training into the performance feedback procedures of a writing intervention using a randomized controlled trial (RCT). Results indicated that although the addition of multiple exemplar training did not improve students' writing performance on measures of stimulus and response generalization, it did result in greater maintenance of intervention effects in comparison to students who received performance feedback without generality programming and students who engaged in weekly writing practice alone.

  9. Technology-enhanced program for child disruptive behavior disorders: development and pilot randomized control trial.

    Science.gov (United States)

    Jones, Deborah J; Forehand, Rex; Cuellar, Jessica; Parent, Justin; Honeycutt, Amanda; Khavjou, Olga; Gonzalez, Michelle; Anton, Margaret; Newey, Greg A

    2014-01-01

    Early onset disruptive behavior disorders are overrepresented in low-income families; yet these families are less likely to engage in behavioral parent training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Low-income families of 3- to 8-year-old children with clinically significant disruptive behaviors were randomized to and completed standard HNC (n = 8) or Technology-Enhanced HNC (TE-HNC; n = 7). On average, caregivers were 37 years old; 87% were female, and 80% worked at least part-time. More than half (53%) of the youth were boys; the average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone enhancements: (a) skills video series, (b) brief daily surveys, (c) text message reminders, (d) video recording home practice, and (e) midweek video calls. TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to postassessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale.

  10. mHealth for Smoking Cessation Programs: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Koel Ghorai

    2014-07-01

    Full Text Available mHealth transforms healthcare delivery around the world due to its affordability and right time availability. It has been used for delivery of various smoking cessation programs and interventions over the past decade. With the proliferation of smartphone usage around the world, many smartphone applications are being developed for curbing smoking among smokers. Various interventions like SMS, progress tracking, distractions, peer chats and others are being provided to users through smartphone applications. This paper presents a systematic review that analyses the applications of mobile phones in smoking cessations. The synthesis of the diverse concepts within the literature on smoking cessations using mobile phones provides deeper insights in the emerging mHealth landscape.

  11. 76 FR 11782 - Medicare, Medicaid, and Children's Health Insurance Programs; Renewal, Expansion, and Renaming of...

    Science.gov (United States)

    2011-03-03

    ... with or who are eligible for Medicare, Medicaid and the Children's Health Insurance Program (CHIP... Insurance Assistance Programs (SHIPs), health insurance plans, aging, Web health education, e-prescribing... insurance exchanges, and minority health education. We are requesting that all curricula vitae include the...

  12. 76 FR 8748 - Loan Repayment Program for Repayment of Health Professions Educational Loans

    Science.gov (United States)

    2011-02-15

    ... Masters level. (f) Dentistry: DDS and DMD. (g) Dental Hygiene. (h) Pharmacy: B.S., Pharm.D. (i) Optometry... HUMAN SERVICES Indian Health Service Loan Repayment Program for Repayment of Health Professions... program in a health profession; or (B) Have a degree in a health profession and a license to practice in...

  13. 78 FR 7787 - Loan Repayment Program for Repayment of Health Professions Educational Loans

    Science.gov (United States)

    2013-02-04

    ...: DDS and DMD. (i) Dental Hygiene. (j) Dental Assistant: Certified. (k) Pharmacy: B.S., Pharm.D. (l... HUMAN SERVICES Indian Health Service Loan Repayment Program for Repayment of Health Professions... program in a health profession; or (B) Have a degree in a health profession and a license to practice in...

  14. SHPPS 2006: School Health Policies and Programs Study--Injury Prevention and Safety

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of injury prevention and safety, covering the following topics: (1) Health Education; (2) Health Services…

  15. SHPPS 2006: School Health Policies and Programs Study--Tobacco-Use Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of tobacco-use prevention, covering the following areas: (1) Health Education; (2) Health Services and…

  16. SHPPS 2006: School Health Policies and Programs Study--Food Safety

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of food safety, covering the following topics: (1) Health Education; (2) Health Services; and (3)…

  17. SHPPS 2006: School Health Policies and Programs Study--Suicide Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School health policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of suicide prevention, covering the following topics: (1) Health Education; (2) Health Services and Mental…

  18. SHPPS 2006: School Health Policies and Programs Study--Pregnancy Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports 2006 study results in the area of pregnancy prevention, covering the following topics: (1) Health Education; and (2) Health Services…

  19. SHPPS 2006: School Health Policies and Programs Study--Violence Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of violence prevention, covering the following topics: (1) Health Education; (2) Health Services and…

  20. SHPPS 2006: School Health Policies and Programs Study--HIV Prevention

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief reports study results in the area of HIV prevention, covering the following topics: (1) Health Education; and (2) Health Services and Mental…

  1. SHPPS 2006 School Health Policies and Programs Study--Crisis Preparedness, Response, and Recovery

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs at the state, district, school, and classroom levels. This brief presents data on crisis preparedness, response, and recovery as it pertains to health services, mental health and social services, nutrition…

  2. Comparative efficacy of aloe vera mouthwash and chlorhexidine on periodontal health: A randomized controlled trial

    Science.gov (United States)

    Jha, Abhishek; Bhashyam, Mamtha

    2016-01-01

    Background With introduction of many herbal medicines, dentistry has recently evidenced shift of approach for treating many inflammatory oral diseases by using such modalities. Aloe vera is one such product exhibiting multiple benefits and has gained considerable importance in clinical research recently. Aim To compare the efficacy of Aloevera and Chlorhexidine mouthwash on Periodontal Health. Material and Methods Thirty days randomized controlled trial was conducted among 390 dental students. The students were randomized into two intervention groups namely Aloe Vera (AV) chlorhexidine group (CHX) and one control (placebo) group. Plaque index and gingival index was recorded for each participant at baseline, 15 days and 30 days. The findings were than statistically analyzed, ANOVA and Post Hoc test were used. Results There was significant reduction (pAloe Vera (AV) and chlorhexidine group. Post hoc test showed significant difference (paloe Vera and placebo and chlorhexidine and placebo group. No significant difference (pAloe vera, chlorhexidine, dental plaque, gingivitis. PMID:27703614

  3. Effectiveness of a capacity-building program for community leaders in a healthy living environment: a randomized community-based intervention in rural Vietnam.

    Science.gov (United States)

    Hien, Le Thi Thu; Takano, Takehito; Seino, Kaoruko; Ohnishi, Mayumi; Nakamura, Keiko

    2008-12-01

    This randomized controlled study was performed to evaluate the effectiveness of an educational program entitled 'Capacity building for community leaders in a healthy living environment,' and to assess the usefulness of a participatory style of education and the applicability of an intersectoral approach in the educational process. An intervention group and a control group (consisting of 150 and 154 community leaders, respectively) were both evaluated, after the intervention group took part in a 5-day participatory-style educational program. Healthy living environment promotion competency (HPC) was evaluated by an instrument consisted of four competency areas: identifying the steps required for a healthy living environment; understanding the principles to reduce potential health risks; providing public health management to improve the living environment; and applying the principles of health communication skills. Scores between the intervention and control groups were examined to identify changes between the baseline and post-intervention periods. A qualitative evaluation of the educational program by participants and facilitators was conducted to assess the appropriateness of the intervention. The results indicated significant increases in the total HPC score and scores of individual HPC competency areas in the intervention group. Thus, the effectiveness of a capacity building program for community leaders in a healthy living environment was demonstrated. Qualitative evaluation revealed that the participatory-style and intersectoral collaboration approach facilitated the educational process. Community leaders, who are representatives of various sectors and mass organizations within the community, can be important implementers in the promotion of a healthy living environment.

  4. Health and safety information program for hazardous materials

    Energy Technology Data Exchange (ETDEWEB)

    O' Brien, M.P.; Fallon, N.J.; Kuehner, A.V.

    1979-01-01

    The system is used as a management tool in several safety and health programs. It is used to: trace the use of hazardous materials and to determine monitoring needs; inform the occupational physician of the potential health problems associated with materials ordered by a given individual; inform the fire and rescue group of hazardous materials in a given building; provide waste disposal recommendations to the hazardous waste management group; assist the hazardous materials shipping coordinator in identifying materials which are regulated by the Department of Transportation; and guide management decisions in the area of recognizing and rectifying unsafe conditions. The information system has been expanded from a manual effort to provide a brief description of health hazards of chemicals used at the lab to a computerized health and safety information system which serves the needs of all personnel who may encounter the material in the course of their work. The system has been designed to provide information needed to control the potential problems associated with a hazardous material up to the time that it is consumed in a given operation or is sent to the waste disposal facility.

  5. Efficiency of mobile dental unit in public health programs

    Directory of Open Access Journals (Sweden)

    Nitin Gupta

    2016-07-01

    Full Text Available Almost all dental Colleges run a mobile dental operation for people living in far inaccessible areas who are not able to avail dental care. Mobile dental clinics provide a mode of reaching the unreached by delivering dental care in areas where alternative i.e. private practitioners and fixed clinics are unavailable or inaccessible. Oral diseases account for high morbidity in the community which is compounded by the gross mal-distribution of provision of oral health services in India. In order to ensure accessibility to basic oral health services innovative models of service delivery are being explored. In this context the health economics of mobile oral health care is critically evaluated in this paper. Thus a cost analysis was undertaken to determine the operating expenses for the existing mobile dental unit. Requisite permission of Head of institution was obtained and data was extracted from the records of the mobile dental unit for the year 2014-15.Information on the operating expenses was collected. Costing was done using step down accounting method. Total operating cost of the unit for the year 2014-15 was Rs. 184888/-.Unit cost for each camp was Rs.3625/- and for each patient Rs.76/-. Mobile dental programs can play a vital role in providing access to care to underserved populations and ensuring their mission requires long-term planning. Careful cost analysis based on sound assumptions is of utmost importance.

  6. International program on the health effects of the Chernobyl accident.

    Science.gov (United States)

    Kreisel, W

    1995-05-01

    The International Program on the Health Effects of the Chernobyl Accident (IPHECA) was established by the World Health Organization (WHO) in 1991. Currently, the technical part of IPHECA consists of five projects addressing the following areas of priority health problems or needs: thyroid, hematology, brain damage in utero, epidemiological registry and oral health. Important findings are: 1) a significant increase of thyroid cancer in children in Belarus and Ukraine since 1989, and in Russia since 1992 though not so pronounced. A relationship between detected thyroid cancers and radiation exposure is yet to be established, 2) no increase yet in the incidence of hemoblastoses in the three States, 3) no relationship established between mental retardation and radiation exposure in utero in 4,500 children investigated. The importance of dosimetry and biological indicators of radiation damage has been recognized by IPHECA. Several methods of biological and physical dosimetry are being employed using instrumentation provided by IPHECA. Some preliminary results indicate: 1) unstable aberrations can indicate an integral exposure but it is heavily biased to recent exposures, 2) when comparing healthy persons and patients with hematological diseases in contaminated areas, there is a higher ratio of total aberrations compared to their background and that the level of stable is lower than unstable aberrations, and 3) by applying electron spin resonance (ESR) it has been shown that the individual distribution of doses approaches a log-normal one, especially for adults, and that a peak shift towards higher doses is noticeable for children.

  7. Effectiveness of a 'Global Postural Reeducation' program for persistent Low Back Pain: a non-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Violante Francesco S

    2010-12-01

    Full Text Available Abstract Background The aim of this non-randomized controlled trial was to evaluate the effectiveness of a Global Postural Reeducation (GPR program as compared to a Stabilization Exercise (SE program in subjects with persistent low back pain (LBP at short- and mid-term follow-up (ie. 3 and 6 months. Methods According to inclusion and exclusion criteria, 100 patients with a primary complaint of persistent LBP were enrolled in the study: 50 were allocated to the GPR group and 50 to the SE group. Primary outcome measures were Roland and Morris Disability Questionnaire (RMDQ and Oswestry Disability Index (ODI. Secondary outcome measures were lumbar Visual Analogue Scale (VAS and Fingertip-to-floor test (FFT. Data were collected at baseline and at 3/6 months by health care professionals unaware of the study. An intention to treat approach was used to analyze participants according to the group to which they were originally assigned. Results Of the 100 patients initially included in the study, 78 patients completed the study: 42 in the GPR group and 36 in the SE group. At baseline, the two groups did not differ significantly with respect to gender, age, BMI and outcome measures. Comparing the differences between groups at short- and mid-term follow-up, the GPR group revealed a significant reduction (from baseline in all outcome measures with respect to the SE group. The ordered logistic regression model showed an increased likelihood of definitive improvement (reduction from baseline of at least 30% in RMDQ and VAS scores for the GPR group compared to the SE group (OR 3.9, 95% CI 2.7 to 5.7. Conclusions Our findings suggest that a GPR intervention in subjects with persistent LBP induces a greater improvement on pain and disability as compared to a SE program. These results must be confirmed by further studies with higher methodological standards, including randomization, larger sample size, longer follow-up and subgrouping of the LBP subjects. Trial

  8. Effects of a self-regulation based physical activity program (the "4-STEPS") for unexplained chronic fatigue: a randomized controlled trial.

    Science.gov (United States)

    Marques, M; De Gucht, V; Leal, I; Maes, S

    2015-04-01

    This study aimed at assessing the effects of a self-regulation-based brief physical activity program for patients suffering from unexplained chronic fatigue, the "4-STEPS to control your fatigue program". A 12-week randomized controlled trial was conducted. Adult patients meeting the CDC criteria for idiopathic chronic fatigue were randomized to either the control condition (standard care) or the intervention condition (4-STEPS). The 4-STEPS was based on self-regulation principles and consisted of motivational interviewing and self-regulation skills training. All patients were assessed at baseline and post-treatment (12 weeks) for fatigue severity (primary outcome) and impact, physical activity (leisure time physical activity, number of daily steps and personal activity goal progress), health-related quality of life, somatic distress and psychological distress (depression and anxiety). Ninety-one patients (45 intervention and 46 control patients) received the allocated intervention. At post-treatment, statistical analysis revealed a significant difference for subjective experience of fatigue (4.73 points; g = 0.51) in favour of the intervention group. Mixed design ANCOVAs showed a significant effect of the 4-STEPS on fatigue severity, leisure time physical activity, personal activity goal progress and health-related quality of life. No significant effects were found for number of daily steps and somatic and psychological distress. The 4-STEPS program has significant beneficial effects at post-treatment. This brief self-regulation-based intervention looks promising for the management of unexplained chronic fatigue. ISRCTN70763996.

  9. Effects of different frequencies (2-3 days/week) of aquatic therapy program in adults with chronic low back pain. A non-randomized comparison trial.

    Science.gov (United States)

    Baena-Beato, Pedro Angel; Arroyo-Morales, Manuel; Delgado-Fernández, Manuel; Gatto-Cardia, Maria Claudia; Artero, Enrique G

    2013-01-01

    To study the effects of an aquatic therapy program with different frequencies (2 vs 3 days per week) in chronic low back pain. [corrected] Non-randomized comparison trial. Sport and spa community health club. Fifty-four adults with chronic low back pain (48.9 ± 10.0 years). Eight-week aquatic therapy program. Pain (visual analog scale [VAS]), disability (Oswestry Disability Index), and quality of life (Short-Form Health Survey 36), body composition (weight, body mass index, body fat mass, body fat percentage, and skeletal muscle mass), and health-related fitness (sit and reach, handgrip strength, curl-up, Rockport 1-mile test). Both experimental groups presented significant improvements in low back pain and disability (P aquatic therapy program decrease levels of back pain and disability, increase quality of life, and improve health-related fitness in adults with chronic low back pain without effects in body composition. A dose-response effect was observed in some parameters, with greater benefits when exercising 3 days per week compared with 2 days. Wiley Periodicals, Inc.

  10. The Effect of India's Total Sanitation Campaign on Defecation Behaviors and Child Health in Rural Madhya Pradesh: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    Patil, Sumeet R.; Arnold, Benjamin F.; Salvatore, Alicia L.; Briceno, Bertha; Ganguly, Sandipan; Colford, John M.; Gertler, Paul J.

    2014-01-01

    Background Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). Methods and Findings We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May–July 2009), and revisited households 21 months later (February–April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%–26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%–15%; group means: 73% intervention versus 84% control). However, the intervention did not improve child health measured in terms of multiple health outcomes (diarrhea, HCGI, helminth infections, anemia, growth). Limitations of the study included a relatively short follow-up period following implementation, evidence for contamination in ten of the 40 control villages, and bias possible in self-reported outcomes for diarrhea, HCGI, and open defecation behaviors. Conclusions The intervention led to modest increases in availability of IHLs and even more

  11. The impact of the Citibank, NA, health management program on changes in employee health risks over time.

    Science.gov (United States)

    Ozminkowski, R J; Goetzel, R Z; Smith, M W; Cantor, R I; Shaughnessy, A; Harrison, M

    2000-05-01

    This study estimated the impact of the Citibank Health Management Program on changes in health risks among Citibank employees. McNemar chi-squared tests compared the probability of being at high risk for poor health when the first and last health-risk appraisal surveys were taken. Logistic regression controlled for baseline differences in subsequent analyses when those who participated in more intensive program features were compared with those who participated in less intensive features. Declines in risk were noted for 8 of 10 risk categories. Most changes were small, except those related to exercise habits, seatbelt use, and stress levels. For nine health risk categories, those who participated in more intensive program services were significantly more likely than others to reduce their health risks. Thus, the Citibank Health Management Program was associated with significant reductions in health risk.

  12. Mobile Technology for Community Health in Ghana: what happens when technical functionality threatens the effectiveness of digital health programs?

    National Research Council Canada - National Science Library

    Amnesty E LeFevre; Diwakar Mohan; David Hutchful; Larissa Jennings; Garrett Mehl; Alain Labrique; Karen Romano; Anitha Moorthy

    2017-01-01

    Background Despite the growing use of technology in the health sector, little evidence is available on the technological performance of mobile health programs nor on the willingness of target users...

  13. An adapted mindfulness-based stress reduction program for elders in a continuing care retirement community: quantitative and qualitative results from a pilot randomized controlled trial.

    Science.gov (United States)

    Moss, Aleezé S; Reibel, Diane K; Greeson, Jeffrey M; Thapar, Anjali; Bubb, Rebecca; Salmon, Jacqueline; Newberg, Andrew B

    2015-06-01

    The purpose of this study was to test the feasibility and effectiveness of an adapted 8-week Mindfulness-Based Stress Reduction (MBSR) program for elders in a continuing care community. This mixed-methods study used both quantitative and qualitative measures. A randomized waitlist control design was used for the quantitative aspect of the study. Thirty-nine elderly were randomized to MBSR (n = 20) or a waitlist control group (n = 19), mean age was 82 years. Both groups completed pre-post measures of health-related quality of life, acceptance and psychological flexibility, facets of mindfulness, self-compassion, and psychological distress. A subset of MBSR participants completed qualitative interviews. MBSR participants showed significantly greater improvement in acceptance and psychological flexibility and in role limitations due to physical health. In the qualitative interviews, MBSR participants reported increased awareness, less judgment, and greater self-compassion. Study results demonstrate the feasibility and potential effectiveness of an adapted MBSR program in promoting mind-body health for elders.

  14. Modeling health impact of global health programs implemented by Population Services International.

    Science.gov (United States)

    Yang, Hongmei; Duvall, Susan; Ratcliffe, Amy; Jeffries, David; Stevens, Warren

    2013-01-01

    Global health implementing organizations benefit most from health impact estimation models that isolate the individual effects of distributed products and services - a feature not typically found in intervention impact models, but which allow comparisons across interventions and intervention settings. Population Services International (PSI), a social marketing organization, has developed a set of impact models covering seven health program areas, which translate product/service distribution data into impact estimates. Each model's primary output is the number of disability-adjusted life-years (DALYs) averted by an intervention within a specific country and population context. This paper aims to describe the structure and inputs for two types of DALYs averted models, considering the benefits and limitations of this methodology. PSI employs two modeling approaches for estimating health impact: a macro approach for most interventions and a micro approach for HIV, tuberculosis (TB), and behavior change communication (BCC) interventions. Within each intervention country context, the macro approach determines the coverage that one product/service unit provides a population in person-years, whereas the micro approach estimates an individual's risk of infection with and without the product/service unit. The models use these estimations to generate per unit DALYs averted coefficients for each intervention. When multiplied by program output data, these coefficients predict the total number of DALYs averted by an intervention in a country. Model outputs are presented by country for two examples: Water Chlorination DALYs Averted Model, a macro model, and the HIV Condom DALYs Averted Model for heterosexual transmission, a micro model. Health impact estimates measured in DALYs averted for PSI interventions on a global level are also presented. The DALYs averted models offer implementing organizations practical measurement solutions for understanding an intervention

  15. A randomized controlled study about the use of eHealth in the home health care of premature infants

    Directory of Open Access Journals (Sweden)

    Gund Anna

    2013-02-01

    Full Text Available Abstract Background One area where the use of information and communication technology (ICT, or eHealth, could be developed is the home health care of premature infants. The aim of this randomized controlled study was to investigate whether the use of video conferencing or a web application improves parents’ satisfaction in taking care of a premature infant at home and decreases the need of home visits. In addition, nurses’ attitudes regarding the use of these tools were examined. Method Thirty-four families were randomized to one of three groups before their premature infant was discharged from the hospital to home health care: a control group receiving standard home health care (13 families; a web group receiving home health care supplemented with the use of a web application (12 families; a video group with home health care supplemented with video conferencing using Skype (9 families. Families and nursing staff answered questionnaires about the usefulness of ICT. In addition, semi-structured interviews were conducted with 16 families. Results All the parents in the web group found the web application easy to use. 83% of the families thought it was good to have access to their child’s data through the application. All the families in the video group found Skype easy to use and were satisfied with the video calls. 88% of the families thought that video calls were better than ordinary phone calls. 33% of the families in the web group and 75% of those in the video group thought the need for home visits was decreased by the web application or Skype. 50% of the families in the web group and 100% of those in the video group thought the web application or the video calls had helped them feel more confident in caring for their child. Most of the nurses were motivated to use ICT but some were reluctant and avoided using the web application and video conferencing. Conclusion The families were satisfied with both the web application and video

  16. Feasibility and Preliminary Outcomes From a Pilot Study of an Integrated Health-Mental Health Promotion Program in School Mental Health Services

    Science.gov (United States)

    George, Melissa W.; Trumpeter, Nevelyn N.; Wilson, Dawn K.; McDaniel, Heather L.; Schiele, Bryn; Prinz, Ron; Weist, Mark D.

    2014-01-01

    The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program. PMID:24297005

  17. Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial.

    Science.gov (United States)

    Eilenberg, T; Fink, P; Jensen, J S; Rief, W; Frostholm, L

    2016-01-01

    Severe health anxiety is frequent and costly, yet rarely diagnosed or treated. Earlier treatment studies show problems with recruitment, dropout and recovery. In the current study, the authors aimed to test the effect of acceptance and commitment group therapy (ACT-G) compared to waitlist in patients with severe health anxiety. During March 2010 to April 2012, 126 consecutively referred patients meeting research criteria for severe health anxiety were block-randomized (1:1) to ACT-G or a 10 months' waitlist (Clinicaltrials.gov, no. NCT01158430). Patients allocated to ACT-G were treated in seven groups of nine patients between December 2010 and October 2012 and received nine weekly 3-h group sessions and a booster session consisting of ACT techniques. The primary outcome was decided a priori as the mean change in self-reported illness worry on the Whiteley-7 Index (WI) from baseline to 10 months' follow-up. Secondary outcomes were improvement in emotional distress and health-related quality of life at 10 months' follow-up. Intention-to-treat analysis showed a statistically significant mean difference of 20.5 points [95% confidence interval (CI) 11.7-29.4, p accepted by the patients. ACT-G seems feasible, acceptable and effective in treating severe health anxiety.

  18. The effects of education based on extended health belief model in type 2 diabetic patients: a randomized controlled trial

    OpenAIRE

    Bayat, Fatemeh; Shojaeezadeh, Davoud; Baikpour, Masoud; Heshmat, Ramin; Baikpour, Maryam; Hosseini, Mostafa

    2013-01-01

    Background Type II diabetes and its complications impose a large economic burden on health care systems. This study aims to assess the effectiveness of educational intervention based on extended health belief model on type 2 diabetic patients. Methods 120 patients with type II diabetes referring to randomly selected hospitals of Tehran University of Medical Sciences were enrolled in this educational intervention study. Patients were randomly divided into two groups (intervention and control)....

  19. Cost-Effectiveness of a Health System-Based Smoking Cessation Program.

    Science.gov (United States)

    Levy, Douglas E; Klinger, Elissa V; Linder, Jeffrey A; Fleegler, Eric W; Rigotti, Nancy A; Park, Elyse R; Haas, Jennifer S

    2016-09-17

    Project CLIQ (Community Link to Quit) was a proactive population-outreach strategy using an electronic health records-based smoker registry and interactive voice recognition technology to connect low- to moderate-income smokers with cessation counseling, medications, and social services. A randomized trial demonstrated that the program increased cessation. We evaluated the cost-effectiveness of CLIQ from a provider organization's perspective if implemented outside the trial framework. We calculated the cost, cost per smoker, incremental cost per additional quit, and, secondarily, incremental cost per additional life year saved of the CLIQ system compared to usual care using data from a 2011-2013 randomized trial assessing the effectiveness of the CLIQ system. Sensitivity analyses considered economies of scale and initial versus ongoing costs. Over a 20-month period (the duration of the trial) the program cost US $283 027 (95% confidence interval [CI] $209 824-$389 072) more than usual care in a population of 8544 registry-identified smokers, 707 of whom participated in the program. The cost per smoker was $33 (95% CI 28-40), incremental cost per additional quit was $4137 (95% CI $2671-$8460), and incremental cost per additional life year saved was $7301 (95% CI $4545-$15 400). One-time costs constituted 28% of costs over 20 months. Ongoing costs were dominated by personnel costs (71% of ongoing costs). Sensitivity analyses showed sharp gains in cost-effectiveness as the number of identified smokers increased because of the large initial costs. The CLIQ system has favorable cost-effectiveness compared to other smoking cessation interventions. Cost-effectiveness will be greatest for health systems with high numbers of smokers and with the high smoker participation rates. Health information systems capable of establishing registries of patients who are smokers are becoming more prevalent. This economic analysis illustrates the cost implications for health care systems

  20. Home-Based Intervention Program to Reduce Food Insecurity in Elderly Populations Using a TV App: Study Protocol of the Randomized Controlled Trial Saúde.Come Senior.

    Science.gov (United States)

    Rodrigues, Ana Maria; Gregório, Maria João; Gein, Pierre; Eusébio, Mónica; Santos, Maria José; de Sousa, Rute Dinis; Coelho, Pedro S; Mendes, Jorge M; Graça, Pedro; Oliveira, Pedro; Branco, Jaime C; Canhão, Helena

    2017-03-13

    The limited or uncertain access to adequate food in elderly people includes not only economic restrictions but also inability of food utilization due to functional or cognitive impairment, health problems, and illiteracy. The aim of this work is to present the protocol of the randomized controlled trial Saúde.Come Senior, an educational and motivational television (TV)-based intervention to promote healthy lifestyles and decrease food insecurity in elderly people. A randomized controlled study will be conducted in subjects aged 60 years and older with food insecurity, identified at 17 primary care centers in the Lisboa e Vale do Tejo health region in Lisbon, Portugal. The primary outcome will be the changes in participants' food insecurity score (evaluated by the Household Food Insecurity Scale) at 3 months. Change in other outcomes will be assessed (dietary habits, nutritional status, physical activity, health status, and clinical outcomes). Subjects will be followed over 6 months; the intervention will last 3 months. Data collection will be performed at 3 different time points (baseline, end of intervention at 3 months, and follow-up at 6 months). The intervention is based on an interactive TV app with an educational and motivational program specifically developed for the elderly that has weekly themes and includes daily content in video format: (1) nutrition and diet tips for healthy eating, (2) healthy, easy to cook and low-cost recipes, and (3) physical exercise programs. Furthermore, brief reminders on health behaviors will also be broadcasted through the TV app. The total duration of the study will be 6 months. The intervention is considered to be effective and meaningful if 50% of the individuals in the experimental group have a decrease of 1 point in the food insecurity score, all the remaining being unchanged. We expect to include and randomize 282 (141 experimental and 141 control) elderly with food insecurity. We will recruit a total of 1,128 subjects